Children's Home run by S P Homes Limited in Lambeth

SC065535 Unique reference number 19 May 2009 Inspection date Cheryl Carter Inspector Key Type of Inspection

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30 December 2008 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 10 Inspection Report: SC065535

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Brief description of the service

This is a children's home which caters for six young people aged 13 to 17 years. It provides supervised care and support for young people from all cultural backgrounds on a medium to long-term basis. The home's is a double fronted house with parking facilities on the drive for up to five cars. It is a well presented home, with easy access to schools, local amenities and transport links.

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Summary

This was an unannounced inspection that focused on all the key standards.

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Summary

The outcome area Staying Safe had a number of shortfalls in key areas. Safeguarding training for staff has not been undertaken for over a year and some staff have had no training at all. There is an absence of consistent practice in response to challenging behaviour. The homes is still not recording all complaints although an action relating to complaints was raised at the last inspection. Young people's records are securely stored however not giving young people a key to their bedrooms undermines their privacy and their dignity.

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Summary

The overall monitoring and reviewing of the home's procedures has not been consistently maintained. There is currently no system in place to inform Ofsted of significant incidents and Regulation 34 monitoring of the home against its statement of purpose is not undertaken. Staff have not received training in restraint techniques and thus feel unable to deal with challenging behaviour. There is no guidance for key workers and how key working reports should be written. The overall quality rating is inadequate. This is an overview of what the inspector found during the inspection.

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Helping children to be healthy

The provision is satisfactory. Children's health is promoted, but areas for improvement were identified. The kitchen was reasonably clean, however, there were door fronts that were falling off their hinges and the extractor fan was not working. The cups and plates in the kitchen were mostly plastic, staff said that this is because young people smash plates and cups when angry.

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Helping children to be healthy

Young people are provided with food in adequate quantities, properly prepared, and nutritious. Menus seen showed that care is taken with regard to young people's cultural, ethnic and religious backgrounds. The menus did not include an alternative or any desserts served to the young people. However young people said that the food is good and they can help themselves to a snack if they are hungry. Young people have opportunity to have some input into the menu during their key work sessions or at the house meetings .

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Helping children to be healthy

Although the home maintains a written record of treatments and illness of young people during their placement, young people did not have individual health care plans and consent to treatment 4 of 10 Inspection Report: SC065535 forms were not always signed. Risk assessments were not dated, consequently there is no indication of when risk assessments were last reviewed and updated. All the young people are registered with a local GP.

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Helping children to be healthy

Young peoples health is not fully promoted by the medication systems in place. Inconsistencies were identified in the recording of medication. Although there is a system in place, records were inaccurate and did not give a full audit trail of medication received in and administered by the home. Staff confirmed that they have received training in the storage and administration of medication. Six members of staff are suitably qualified to administer first aid and first aid boxes are provided within the home.

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Protecting children from harm or neglect and helping them stay safe

The provision is inadequate. Young people’s privacy is not fully respected. Each young person has a single occupancy bedroom with appropriate locks for privacy. However none of the young people have keys to their rooms as a result young people do not have the freedom to leave and enter their rooms without asking the staff and as a result often leave their rooms unlocked which can give opportunities for others to enter their rooms without permission. There were no risk assessments or rationale on file that informs why a young person is unable to have a key to their room.

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Protecting children from harm or neglect and helping them stay safe

Children's welfare is not protected. At the previous inspection an action was raised relating to complaints, this has not been appropriately addressed and as a result not all complaints are recorded with the action taken and the outcome of the complaint.

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Protecting children from harm or neglect and helping them stay safe

The staff at the home are aware of safeguarding procedures and the appropriate responses to any allegation or suspicion of abuse. However, training in measures to safeguard children has not been undertaken by all of the staff team. Since March 2008 none of the staff have completed child protection training.

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Protecting children from harm or neglect and helping them stay safe

There have been a number of incidents in the home that have left young people and the staff feeling vulnerable and afraid for their safety. Since January 2009 there have been 18 incidents some very violent and needing the police to be called and both a staff and a young person have had to receive hospital treatment as a result of these incidents in the home. There were no risk assessments or unit plans in place to assist staff to manage these situations and staff have not had any training in restraint and no training to manage the behaviour of the young person at the centre of these incidents. There was only one incident of restraint recorded.

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Protecting children from harm or neglect and helping them stay safe

Young people have concerns relating to bullying and a young person spoken to expressed her fears about living at the home and the staff's inability to safeguard her from attacks by another young person. Records seen showed that the staff team expressed their concerns about the frequency of the incidents occurring in the home, the police being called and the risk of either staff or young people being injured. The staff have expressed concerns that they have had no training in restraint and are therefore unable to manage the incidents appropriately.

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Protecting children from harm or neglect and helping them stay safe

The home has a system in place to record when young people go missing. Young people who are absent without authority are protected in accordance with written guidance and are responded to positively on return. 5 of 10 Inspection Report: SC065535 Significant events relating to the protection of children and young people are not notified to all the appropriate authorities. None of the incidents where staff or young people have been hurt and in need of hospital treatment or where it was necessary to call the police to the home have been reported to Ofsted. It is also unclear when a significant event relates to behaviour, how the home addresses the issue, to ensure all areas of risk have been explored and managed appropriately.

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Protecting children from harm or neglect and helping them stay safe

The records of sanctions are unclear and not recorded consistently and there were no records of rewards. The record of restraint was inconsistent with the number of incidents at the home. The staff have not received the appropriate training to manage challenging behaviour.

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Protecting children from harm or neglect and helping them stay safe

Health and safety checks are carried out appropriately. The current insurance certificate was not displayed although it was seen. Fire drills are carried out monthly. Young people are confident that staff know the procedures to take in the event of a fire.

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Protecting children from harm or neglect and helping them stay safe

Staff recruitment files are kept centrally by the provider, these were provided for inspection. The file relating to two recently recruited members of staff contained the required documentation, however there was inadequate evidence that negative information was being properly explored prior to the decision taken to employ, and in one instance it was unclear who had written references for an employee as they were unsigned. Criminal Records Bureau (CRB) checks had been obtained. A record of all visitors to the home is kept.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. Young people receive individual support provided for them through key worker sessions and general day-to-day contact. Care plans identify the support needs of the young people however, how these needs are met on a day to day basis is not clear as there are no individual plans that addressed specific issues in relation to culture, religion, race and language promoting young people's rights.

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Helping children achieve well and enjoy what they do

Young people are encouraged to achieve regular attendance at school or college and are supported to gain access to educational facilities both at school and in further education in line with their aptitude, needs and interests. The home supports young people to continue their education by providing transport and in some instances escorts to and from school. Two young people are attending college and one young person is currently receiving home tuition. For young people who are excluded from school staff actively liaise with the placing authority to secure appropriate educational provision and a range of equipment and materials are available in the home.

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Helping children achieve well and enjoy what they do

Young people are supported by staff to engage in leisure activities. Young people indicated that they are offered a range of activities some home-based and some outside of the home.

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Helping children make a positive contribution

The provision is satisfactory. Young people's needs are identified in care plans provided by the placing social workers, however there are no unit plans to show how identified needs are met on a day to day basis. Risk assessments are in place however these are not dated and did not indicate when or how often risk assessments are to be reviewed and updated. 6 of 10 Inspection Report: SC065535 Young people's care is monitored via the statutory looked after children's reviews; young people are encouraged to attend and contribute to the process. Staff also participate by providing written reports and attending meetings.

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Helping children make a positive contribution

Young people are able to maintain constructive contact with their families and friends. Practical support for contact is provided, such as transport for family home visits, providing staff for supervised visits and making phone calls. Details of arrangements are recorded in young people's files so that staff are fully aware of any potential restrictions or risks. Young people confirmed they were able to have friends visit the home.

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Helping children make a positive contribution

Young people are supported to move into and leave the home in a positive manner. The home tends to take young people in emergencies and a placement meeting is usually held within 72 hours of the young person being placed. Admission criteria is covered in the home's Statement of Purpose and young people are given a handbook on admission to the home outlining various aspects of the home, explaining rules and routines, what they can expect, who staff are and how to complain.

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Helping children make a positive contribution

Young people have opportunities to voice their opinions and make decisions about their lives. Regular house meetings, key work sessions and the reviewing process provide young people with opportunities to discuss group or individual matters. Young people feel staff are approachable and listen to their views.

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Achieving economic wellbeing

The provision is satisfactory. Young people have the opportunity to work towards independence in preparation for adulthood. Staff provide young people with the chance to learn and practice life skills, including budgeting, laundry, cooking, self care skills and keeping their space clean. Young people's clothing and personal requisite needs are fully met

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Achieving economic wellbeing

The home is decorated and furnished to a good standard with domestic style facilities that create a homely environment, appropriate to the numbers of young people and gender mix. Young people benefit from single rooms which they are encouraged to personalise. There are a number pf outstanding repairs needed in the home. Kitchen cupboard doors are falling off and the extractor fan is not working. There is strong odour of urine in the upstairs corridor.

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Organisation

The organisation is inadequate. The home has a Statement of Purpose that provides interested parties with information about the home, however this has not been updated to ensure that the information continues to be accurate. A guide is available for young people giving them detailed information about what services they can expect and how they will be cared for whilst living in the home.

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Organisation

The staff team at the home is fairly stable and some of the staff are very experienced and qualified to work with young people. Not all the staff have the minimum NVQ Level 3 qualification that is a requirement for caring for children. Not all staff are skilled or trained to deal with children presenting challenging behaviour. Although the manager says that the home is committed to providing staff with opportunities for further training including regular updates of mandatory courses there was no planned programme for staff. 7 of 10 Inspection Report: SC065535 The home provides both male and female staff to work with a mixed group of young people. Staff are clear about the management structure and aware of any additional responsibilities they may have, such as acting as shift leader. However the post of deputy manager has been vacant for over six months and the lines of accountability within the home are unclear. Staff

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Organisation

rotas have time scheduled for handover sessions, key working and administrative tasks to ensure young people's overall care is not compromised. Good systems are in place for staff communication, however there have clearly been a number of incidents in the home that have not been recorded or reported to the appropriate agencies.

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Organisation

Regulation 33 visits are conducted monthly and reports are written by the appointed visitor. There is currently no system in place to monitor the home against the Statement of Purpose as set out in Regulation 34. Young people are routinely consulted about matters concerning them and monthly summaries are produced for each young person. Staff meetings occur weekly to enable staff to discuss and to monitor the welfare of young people and to pass on concerns about the care of the children to management.

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Organisation

Young people's files are kept securely and comply with the legal requirements of all the information that needs to be kept.

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Organisation

The promotion of equality and diversity is satisfactory. There is some commitment to improving the equality and diversity practice in the home, such as the staff team reflecting the diverse needs of the young people placed. Additionally, there has been no attempt to update policies to include equality and diversity into the policies and procedures of the home.

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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

16 June 2009 ensure that all young people have individual health care plans in place (Regulation 20.1) 16 June 2009 ensure the system for recording receipt, administration and safe disposal of medication received into the home provides a thorough and accurate audit trail (Regulation 21) 16 June 2009 ensure that all complaints are recorded, the action taken in response and the outcome of the investigation (Regulation 24.5) 16 June 2009 ensure that unnecessary risks to the health or safety of children accommodated in the home are identified and so far as possible eliminated. (Regulation 23 c) 16 June 2009 ensure that any events as listed in column 1 of the table in Schedule 5 is notified without delay to Ofsted (Regulation 30) 8 of 10 Inspection Report: SC065535 16 June 2009 The registered person must ensure risk assessments regarding behaviour management are in place, and these are assessed, reviewed and updated regularly when any changes occur.

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Due date Action Standard

(Regulation 23 & 17) 16 June 2009 ensure that staff are appropriately skilled and trained to support the needs of young people placed in the home such as undertaking training in challenging behaviour management. (Regulation 27) 16 June 2009 ensure all person’s employed have in place, prior to their employment, two written references, including a reference from the persons most recent employer. Any issues arising from these must be followed up and a record of additional verbal evidence from the referee maintained (Regulation 26, Schedule 2) 16 June 2009 ensure that each young person is appropriately supported around their overall care and support needs. Any change such as a new key worker or a change in the individual's care need is discussed appropriately with all parties concerned. (Regulation 11) 16 June 2009 ensure that there is in place clear guidance for staff in undertaking key working roles. (Regulation 11)

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Due date Action Standard

16 June 2009 ensure that the home is kept clean and reasonably decorated and maintained (Regulation 31.2e) 16 June 2009 ensure that the home is kept free from offensive odours (Regulation31.3) 16 June 2009 ensure that a current certificate of insurance is displayed. (Regulation 36) 16 June 2009 ensure that the children's guide is produced in a form appropriate to the age, understanding and communication needs of the children accommodated in the home (Regulation 4.4) 16 June 2009 ensure that all persons employed in the home receive appropriate training, supervision and appraisal and are enabled from time to time to obtain further qualifications appropriate to the work they perform. (Regulation 27.4 a & b) 16 June 2009 ensure that there is a system in place for the monitoring of the matters set out in Schedule 6 and improve the quality of care provided in the home (Regulation 34.1 a & b)

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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 menus reflect all the meals prepared for young people in the home (NMS 10) • ensure that consent to medicals forms are signed for each young person (NMS 12) 9 of 10 Inspection Report: SC065535 • ensure that the practice of not giving young people keys to their rooms is reviewed (NMS 9) • ensure that all staff training relating to safeguarding children is updated (NMS 17) • ensure that there is a system in place to record incidents of bullying (NMS 18) 10 of 10 Inspection Report: SC065535

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