Children's Home run by Young Alliance Limited in Cheshire East

SC381531 Unique reference number 14 January 2010 Inspection date Paul Gillespie Inspector Key Type of Inspection

p.1

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.

p.2

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

p.2

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.

p.3

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 10 Inspection Report: SC381531

p.3

Brief description of the service

This home is a highly specialised children's home that is provided by a private residential childcare provider in partnership with an independent healthcare provider. The service provides residential care for children and young people who have experienced moderate to serious mental health problems. The home offers a therapeutic environment that will facilitate a transition between inpatient treatment and integration into the community.

p.4

Brief description of the service

Two young people were resident at the time of the visit who both contributed towards the inspection.

p.4

Summary

At this unannounced full inspection all the key standards were inspected. The main focus of the inspection was to find out how well the home meets the needs of young people living there and to review the progress made in addressing the actions and recommendations made at the last inspection.

p.4

Summary

This is a good service. It is very well run and effectively managed by a committed and competent management team. The home provides a friendly, safe and stable environment. This enables young people to make good progress in all aspects of their lives, especially their personal safety and their social and emotional development in coming to terms with their life experiences. Other key strengths include the comprehensive approach to risk management and the very good collaboration between the home and other agencies involved in the care of young people. Young people's health needs are very well met.

p.4

Summary

Young people are happy and enjoy living at the home. They confirm that they are very well looked after and get all the help they need from staff described as 'really good'. They are looked after by a skilled and settled staff team. This has enabled young people to build positive relationships with adults based on trust and respect and to have consistent adult role models. The staff's thorough understanding of young people as individuals and the quality of support and guidance assists young people to deal with the problems they face positively and to feel part of the wider community.

p.4

Summary

The management of the home does however need to ensure that all notifications are submitted as required. Additionally, identifying the likelihood and severity of risk within the current documentation associated with young people would further improve the robustness of the risk assessment process. Also, consistently including feedback regarding the quality of care in the home from young people, their families or social workers would provide additional evidence of the good work taking place in supporting young people. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

p.4

Improvements since the last inspection

The home has taken appropriate action to fully address four of the five actions and three of the four recommendations made at the last inspection. The home now ensures all staff are appropriately checked and vetted prior to commencing employment, including securing criminal records bureau (CRB) checks and full employment histories. All of the required records and 4 of 10 Inspection Report: SC381531 documentation for young people, such as review minutes, have also been secured. This means young people are better protected and that staff now have the necessary documentation to fully inform the care planning processes. The level of staff who now hold a qualification at or equivalent to National Vocational Qualification at level 3 or are working towards this has also improved. This means young people are supported by a trained and competent staff group. However, the submission of notifications has yet to be satisfactorily addressed and is therefore

p.4

Helping children to be healthy

The provision is good. The home actively promotes young people's physical health and emotional well being. All young people have a thorough health needs assessment as part of a planned admission. Their general and specific health needs are clearly identified in comprehensive individual health plans, which also show the arrangements for meeting their needs. Health plans identify any issues arising from young people's cultural background, gender and disabilities.

p.5

Helping children to be healthy

Young people are registered with a local doctor, dentist and optician. Staff monitor young people to make sure they are healthy by encouraging them to attend routine health checks and by ensuring they get medical treatment when they are unwell. The home has excellent links with specialist health and advisory services, such as psychology and counselling services. This ensures that young people get the necessary support with specific issues. Staff support and encourage young people to follow therapeutic programmes and are very alert to changes in mood, behaviour and general wellbeing of young people that can occur as a result of the specialised nature of the support offered. They are able to take sensitive action to support young people should this be necessary.

p.5

Helping children to be healthy

The promotion of healthy lifestyles is successfully integrated into the running of the home. Staff always encourage young people to take an interest in looking after their health and to lead healthy lives. Young people spoke about receiving 'plenty of advice' about keeping healthy. Staff ensure that young people have good access to information about a range of health and social issues. They provide very good advice on diet and nutrition, personal care, and exercise to help young people develop healthy lifestyles.

p.5

Helping children to be healthy

The home also ensures that young people's health needs are particularly well met and protected by very detailed and clear medication procedures, which staff consistently put into practice. Medication is securely stored and records of any medication taken by young people are up-to-date and accurately kept. Staff make sure that young people only have medication specifically prescribed for them and take it in line with the prescription instructions. Staff are trained in managing medication and first aid and this means their welfare is safeguarded.

p.5

Helping children to be healthy

Young people enjoy healthy and nutritious meals that cater for varying cultural and dietary needs. Staff encourage young people to have a varied diet from fresh ingredients including chicken, fish, vegetables and fruit. Their food choices are always taken into account and confirm that they are actively encouraged to help plan meals, decide what to have to eat, buy food and cook meals. Staff fully understand the importance of good nutrition and what makes up a balanced diet. They regularly encourage young people to try new food and recipes and experience food from different cultures both at home and within the wider community at a variety of different restaurants. 5 of 10 Inspection Report: SC381531

p.5

Protecting children from harm or neglect and helping them stay safe

The provision is good. The home's policies and practices promote young people's privacy and confidentiality very well. They have single bedrooms and are assured of privacy when washing and with their personal hygiene. The accommodation provides space where young people can relax easily and to spend time to be alone when they wish. Staff respect young people's privacy consistent with good parenting and the need to protect young people. Confidential information is held securely and the approach to managing sensitive information is a key strength that helps safeguard young people.

p.6

Protecting children from harm or neglect and helping them stay safe

The home gives protecting young people from harm a high priority. Young people confirm that they feel safe due to the level of supervision and support provided. Staff fully understand about their roles and responsibilities to promote and safeguard young people’s welfare and receive regular training in child protection. They also have access to the local safeguarding children procedures.

p.6

Protecting children from harm or neglect and helping them stay safe

The staff team at all levels have a thorough understanding of risk assessment processes which are underpinned by promoting independence, choice and autonomy. They put comprehensive and thorough risk management and safeguarding policies and procedures into practice. For example, they ensure that young people have frequent opportunities to access community services and that they are safely supported to do so based on their abilities and level of understanding. However, although risk assessments are very thorough, identifying the likelihood and severity of the risk would further improve the robustness of the process.

p.6

Protecting children from harm or neglect and helping them stay safe

All staff working at the service know the importance of taking the views of young people seriously and of listening to and responding to issues raised. Young people know how to complain. They are confident about talking to staff if they are unhappy and that their concerns or problems are always addressed well by staff. The complaints procedure is accessible to young people and is suitable for their needs, age and level of understanding. The home has received no complaints since the last inspection.

p.6

Protecting children from harm or neglect and helping them stay safe

Young people reported that they do not experience bullying. Staff encourage young people to tell them about anything that may be upsetting them and take appropriate action to tackle any problems should they arise. The home also has comprehensive policies and risk assessments for countering bullying.

p.6

Protecting children from harm or neglect and helping them stay safe

Young people have individual risk assessments and plans outlining what to do if they go missing. The plans thoroughly describe what action is taken, who is to be notified and the timescales for reporting them missing. This includes effective working practices and communication with the police which ensures young people are kept safe. The home has improved the notification of relevant matters under schedule 5 however, this is not yet consistently occurring.

p.6

Protecting children from harm or neglect and helping them stay safe

The home's comprehensive individual behaviour management plans and risk assessments actively encourages acceptable behaviour and ensures challenging behaviour is effectively addressed. Young people know what standards of behaviour are expected. The said that they knew what sanctions can be imposed and felt that they were 'fair overall'. 6 of 10 Inspection Report: SC381531 Young people live in a safe environment. They are protected by a comprehensive range of detailed health and safety procedures and risk assessments. Staff carry out regular health and safety checks, including fire drills, in line with the regulations to ensure the premises are safe and secure.

p.6

Protecting children from harm or neglect and helping them stay safe

The recruitment and selection of people working at the home is very thorough to make sure young people are protected. All staff working at the home have had appropriate checks including a criminal records bureau (CRB) check.

p.7

Helping children achieve well and enjoy what they do

The provision is good. Staff see young people in a very positive light and are committed to helping them when they are anxious or upset. They are very knowledgeable about young people's individual behaviours and are very good at talking to young people to offer suitable advice and reassurance. For example, when young people become worried about arrangements for visits or going out on an activity staff carefully explain what will happen and at what time. In addition, staff provide young people with a variety of social experiences to help them build up their confidence, social skills and competence, to know what is acceptable behaviour in different settings. This helps in reducing young people's level of anxiety and high risk behaviour.

p.7

Helping children achieve well and enjoy what they do

Young people's plans are highly individualised and are regularly reviewed within a multi-agency framework. The service has a ‘can do’ attitude and risks are managed positively to help young people using the service to lead the life they want. Any limitations on choice are always agreed, fully documented and reviewed regularly. In addition, the home has well-established and effective links with a variety of services, such a specialist health services to ensure that young people have full access to the right support to meet their specific needs.

p.7

Helping children achieve well and enjoy what they do

Young people receive very good individual support and guidance when they need it. Young people commented that ‘we have regular key worker sessions’ and staff ‘help us to talk about thing’s’. For example, staff encourage young people to develop their social skills and confidence in groups by taking part in activities in the community, such as going to theatres, restaurants, cinema and shopping.

p.7

Helping children achieve well and enjoy what they do

Young people's education and learning is enhanced and supported. Their placement plans provide good detail about their learning needs and aspirations and how these are supported. Young people are involved in plans for their learning and commented that they are encouraged to understand the importance of education as part of their preparation for adulthood.

p.7

Helping children achieve well and enjoy what they do

Staff actively encourage young people to enjoy their spare time and to take part in leisure activities at home and in the community. Young people enjoy a wide range of activities such going out for meals, ice skating, swimming and trips to the theatre.

p.7

Helping children make a positive contribution

The provision is good. The home’s own records provide a very thorough insight into the individual needs of young people and the plans in place to meet them. Young people have written placement plans identifying their needs and outlining the arrangements for meeting them. These are mapped against the every child matters outcome areas and focus on preparation for independence and 7 of 10 Inspection Report: SC381531 learning life skills. Staff put the plans into practice very well and keep detailed records about young people’s progress, experiences and achievements. Young people’s plans are reviewed regularly by key workers to make sure that they are up-to-date and continue to meet their needs. Fortnightly meetings with health colleagues support this process.

p.7

Helping children make a positive contribution

Staff actively ensure young people have suitable regular contact and that the arrangements promote and safeguard young people’s welfare. This helps to maintain and build positive relationships subject to appropriate risk assessment.

p.8

Helping children make a positive contribution

Staff provide very good emotional and practical support for young people when moving into or leaving the home. They contribute fully to assessments and share information about young people's needs and progress appropriately with relevant authorities. This involvement means that any anxieties can be effectively managed so any change can be seen as a positive experience.

p.8

Helping children make a positive contribution

Young people are encouraged to make decisions about their lives and to influence the way the home is run. They are involved in decisions about what food they eat and what they do in their spare time. Young people’s views are actively sought about how well they feel they are looked after.

p.8

Helping children make a positive contribution

Young people report that staff are 'really good' and are 'very helpful'. The home has a friendly and supportive atmosphere. Young people enjoy very good relationships with staff based on honesty and respect. Staff are very helpful and enjoy spending time with young people. They clearly like young people as individual characters. They have clear professional and personal boundaries with young people that is consistent with good child care practice.

p.8

Achieving economic wellbeing

The provision is good. The home provides a physical environment that meets the specific needs of the young people who live there. It is comfortable and there is an ongoing programme set out to improve the standard of decoration and accommodation. Young people like the accommodation and have personalised bedrooms to reflect their interests and individual tastes.

p.8

Achieving economic wellbeing

The home has efficient systems to ensure effective safeguarding and management of young peoples money and valuables, including record keeping. Young people are supported to manage their own money where possible.

p.8

Achieving economic wellbeing

Young people receive very good support in preparation for the transition into adulthood within a multi-agency framework. Individual plans identify the support that is needed to assist young people to develop the skills, knowledge and confidence they require. Young people report they are involved in making decisions about what support they need and plans include needs arising from their cultural background, gender, and disability.

p.8

Achieving economic wellbeing

Young people routinely take part in the daily tasks of running the home, such as shopping, cooking, laundry, cleaning and understanding budgeting. This results in them developing a wide range of life skills to support them in the future.

p.8

Achieving economic wellbeing

Young people are encouraged to express their individuality. They are involved in choosing how to spend their pocket money and allowances for toiletries and clothing. Staff provide very good 8 of 10 Inspection Report: SC381531 advice around understanding money. They also support young people in claiming the financial support they are entitled to.

p.8

Organisation

The organisation is good. The promotion of equality and diversity in the home is good. There is a consistent commitment to delivering equality and diversity in practice. The home provides care and accommodation for young people with a range of complex behavioural, emotional and social needs. All staff understand and are aware of the specific nature and uniqueness of the home, its aims and objectives and how care will be delivered. They recognise young people as individuals with different needs, backgrounds, interests and views. They ensure that young people receive an individual service designed to meet their personal needs.

p.9

Organisation

Staff have a very thorough knowledge of the young people they are working with ensuring their needs are consistently met. The home values the rights of individuals. Staff encourage young people to find out about the wider community by helping young people to be socially skilled and to play an active part in the community.

p.9

Organisation

The ethos of the home is open and transparent. The views of young people and staff are listened to, and valued. Staff comments about the management of the service include there being a ‘caring supportive management for staff and young people’, ‘I am well supported' and ‘the staff team work closely together'. This is indicative of a strong commitment from the homes management and staff to provide young people with a home environment where they are safe and able to develop their skills and abilities whilst addressing the fundamental reasons as to why they are placed there.

p.9

Organisation

Young people know what support they can expect from the home and how they will be looked after. The children's guide provides important information about the home in a way that is easily understood by young people. In addition, the home has a clearly written statement of how the home operates and plans to meet young people’s needs.

p.9

Organisation

Young people are looked after by a competent staff group who have a very good range of skills and experience. Their skills match the needs of young people living in the home well and reflects the cultural backgrounds of the young people. The roles and responsibilities of staff are clearly defined and understood and they provide positive role models for young people.

p.9

Organisation

The staff themselves are supported by a very competent management team. They receive support through regular supervision and team meetings with staff reporting that “supervision is really good” and “I always enjoy supervision.” The staff training programme offers a good range of training that covers the needs of young people and provides staff with the skills and knowledge to effectively do their jobs. Staff commented that there is ‘lots of training’ and the majority of staff now have a recognised childcare qualification, National Vocational Qualification at level 3 or above or an equivalent qualification.

p.9

Organisation

The current temporary managerial arrangements in the absence of the Registered Manager has ensured that there is a continuity of leadership that has meant that the home is well run and effectively managed. There is good external monitoring of the home and monthly reports are produced that are regularly submitted to Ofsted as required. However the detail of the manager's 9 of 10 Inspection Report: SC381531 monthly monitoring under Regulation 34 does not yet consistently include feedback regarding the quality of care in the home from young people, their families or social workers.

p.9

Organisation

Record keeping is of a good standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act and the importance of confidentiality. Young people can gain access to their records and are encouraged to contribute to them.

p.10

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.

p.10

Due date Action Standard

12 February 2010 ensure that all significant incidents are notified to Ofsted. (Regulation 30)

p.10

Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure that risk assessments include an assessment of the likelihood and severity of the risk identified (NMS 26.2) • consistently include stakeholders' feedback regarding the quality of care in the home, within the manager's Regulation 34 reports. (NMS 33) 10 of 10 Inspection Report: SC381531

p.10