Children's Home run by Courtyard Care Limited in Bolton

SC389823 Unique reference number 25 January 2010 Inspection date Helen Walker 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 9 Inspection Report: SC389823

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Brief description of the service

This home is registered to provide care and accommodation for up to five young people of either gender aged from five to 17 years with learning disabilities.

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Brief description of the service

The home is a spacious detached property situated off a main road in a residential area of the town. To one side and the front of the property, there is an area for car parking. To the other side and the front of the home, there is an enclosed private garden.

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Brief description of the service

On the ground floor of the home are two lounges, kitchen, dining room, utility room, relaxation room, toilet, and manager's office. On the first and second floor are the young people's individual bedrooms, two bathrooms, staff sleep-in rooms and staff office. The home is situated within easy access to local community and leisure facilities.

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Brief description of the service

At the time of the visit three young people were present.

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Summary

This home was first registered in May 2009. At this first full unannounced inspection all the key national minimum standards relevant to a children's home were inspected.

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Summary

Young people using this service have learning difficulties and throughout their daily routines have the support of staff. Some young people have limited communication skills, however, staff use different ways to communicate including 'signing' and pictorial references.

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Summary

Young people's health needs are positively promoted. A healthy lifestyle is encouraged and staff ensure young people have a varied and nutritious diet. Staff take all reasonable steps to keep young people safe from harm and know how to respond in the event of any allegation or serious concern about a young person's safety.

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Summary

Education is seen as an important part of young people's lives and staff assist with homework and ensure regular attendance at school. Liaison between staff and young people's schools is good. Young people are looked after by a caring staff team who have a range of experience and an understanding of their needs.

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Summary

Actions and recommendations to ensure the young people's welfare is fully promoted have been made. These relate to the recording of medication, staff qualifications and monitoring of the home's records, the use of the relaxation room, fire safety, and to increase the homely appearance of some of the communal rooms. 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

Not applicable; this is the first inspection of the home.

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Helping children to be healthy

The provision is good. 4 of 9 Inspection Report: SC389823 The home has a well-furnished dining room, which gives the young people the opportunity to sit at the dining table and to have their meals with the other young people and staff. The variety of meals and the enthusiastic support from staff allows young people to have a balanced diet and choice of foods. Young people also sample foods associated with different countries and cultures, for example, India and China. Snacks, including fresh fruit, are readily available in the home.

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Helping children to be healthy

Prior to a young person's admission to the home their health needs are identified and appropriate resources and support are sought for them. The manager and a member of staff are registered nurses and knowledgeable about the health and medical needs of the young people. Staff positively promote the young people's good health. Contact with various health professionals means young people have access to specialist services, for example, paediatrician and dietician. Young people are registered with the usual primary health care services so that their routine health needs are met.

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Helping children to be healthy

Activities, such as walking, swimming and the use of the trampoline in the garden are actively promoted to enable young people to gain the physical health benefits associated with these activities.

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Helping children to be healthy

The home has guidance in place for the safe storage, administration and disposal of medicines. Medicines are securely and safely stored in the home out of the reach of the young people. Staff are trained in first aid and the safe administration of medicines. However, recording of medication is not always accurate. This means the administration process is not fully robust to protect the welfare of young people.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Young people's privacy and confidentiality is well-regarded in the home. Staff follow guidelines on the provision of personal care, for example, bathing, which helps to maintain young people's dignity.

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Protecting children from harm or neglect and helping them stay safe

An open and robust complaints system is in place to ensure any complaint is dealt with quickly and appropriately. Complaints are investigated thoroughly so that young people's care is not compromised. Staff have a good awareness about how the young people express their feelings, which is important as young people who use this service have limited communication abilities. Agencies, such as health and education, are involved with the young people, which allows for their well-being to be considered by people independent of the home.

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Protecting children from harm or neglect and helping them stay safe

Staff take all reasonable steps to keep young people safe from harm and are aware of the action to take in the event of any allegation or child protection concern. Staff receive safeguarding training to help them in their work to protect and promote the welfare of young people. No young people have been missing from the home. If this should happen, staff know the guidelines to follow to ensure the safety of the young person.

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Protecting children from harm or neglect and helping them stay safe

There have been times when young people's behaviour has impacted on others living in the home, for example, through biting or spitting. Management have taken an active approach to raise staff awareness regarding supervision of young people. This includes an increase in staff on duty and updated risk assessments to reduce or eliminate this type of anti-social behaviour, as well as protecting young people from bullying. 5 of 9 Inspection Report: SC389823 Staff are attentive towards the young people and understand the need to promote positive behaviours. Staff receive training in the use of behaviour management techniques that include the use of physical intervention. The sanction book is not routinely monitored and signed by the manager to evidence the effectiveness of disciplinary measures used by staff. However, the manager has now taken action to ensure sanctions given are appropriate and take account

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Protecting children from harm or neglect and helping them stay safe

of the young people's level of understanding.

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Protecting children from harm or neglect and helping them stay safe

There are times when physical intervention is used in the home to prevent young people from causing significant harm to themselves or others. This includes the use of the 'relaxation' room where young people have 'time out'. This is currently an empty carpeted room with soft padded walls and minimal natural light. Some records show young people are taken to this room rather than them having a choice to use the room.

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Protecting children from harm or neglect and helping them stay safe

Additionally, one young person was left in the 'relaxation' room by themselves with staff outside the room with the door closed. This is a means of compliance and does not promote the welfare and well-being of young people. No guidance is in place to direct staff on the use of this room. The manager confirms this room is no longer used and will eventually be fully equipped to provide a sensory facility for the young people.

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Protecting children from harm or neglect and helping them stay safe

Young people have praise and rewards from staff as a means of encouraging suitable behaviour and celebrating achievements. This includes young people enjoying trips out of the home and on the evening of the inspection a visit to the shops was organised.

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Protecting children from harm or neglect and helping them stay safe

Health and safety systems are in place. Equipment and installations are serviced as required to ensure they are safe to use in the home. However, young people's well-being is not fully safeguarded as the hot water from the bathroom washbasin is hotter than the recommended 43°C. Also a formal fire evacuation drill has yet to be undertaken and recorded to show that staff and young people are familiar with the procedure.

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Protecting children from harm or neglect and helping them stay safe

There are thorough recruitment and employment procedures for staff who work in the home. Appropriate checks are in place to help to ensure staff are suitable to work with young people.

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive good support from staff and other agencies, such as health and education. Young people are allocated key workers on admission to the home, to provide them with individual support in addition to that from other staff members. As some of the young people have little verbal communication, the staff are able to support them through other methods of communication, such as the use of pictures and symbols.

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Helping children achieve well and enjoy what they do

Education is seen by staff as a significant part of young people's lives and is well-promoted in the home. All young people attend school and staff have established good links with teaching staff. The use of 'home to school' books means staff have an overview of what the young person has done during the school day. Personal education plans are available for young people and show how the home are to support and assist young people with their educational needs.

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Helping children achieve well and enjoy what they do

Within the home activities include lots of arts and craft materials, music systems, books, television and games. Young people have access to the office computer with arrangements in hand for them to have a computer in a lounge at the home. Few young people receive homework. 6 of 9 Inspection Report: SC389823 However, those with homework tasks are well-supported and encouraged by staff to complete them.

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Helping children make a positive contribution

The provision is good. Young people's care plans contain information relating to their individual care needs and these are linked to risk assessments that outline how their needs are to be met. Staff present as knowledgeable and aware of the plans to help them provide appropriate care to the young people. Care plans are reviewed monthly to consider any changing care needs of the young people.

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Helping children make a positive contribution

Young people's contact with family and friends is actively promoted and this is done in line with care plans. The promotion of contact means young people continue to have positive links with those who are important to them outside of the home.

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Helping children make a positive contribution

The home has well-established and thorough systems in place to review young people's care. Liaison with social workers means review meetings are timely and involve relevant and significant persons. Staff take an active role in encouraging the young people to attend their review taking account of their level of understanding. Key workers provide reports to the meeting on the young person's welfare and progress, to enable informed discussion in respect of their placement.

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Helping children make a positive contribution

The manager is persistent to obtain the minutes from statutory review meetings. Where these are not forthcoming, full information is recorded in young people's files so that staff are aware of the outcome of the review meeting and any action to be taken.

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Helping children make a positive contribution

Admissions to the home are usually planned and wherever possible involve a visit by the young person to meet staff, young people and see the home. Young people who leave care from this home tend to continue to have support into their adult life. Staff work with young people for them to have a planned ending to their placement in the home.

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Achieving economic wellbeing

The provision is good. None of the young people currently living in the home are of leaving care age and all need support with their care. Staff assist young people to develop skills in line with their age and abilities, and undertake activities to promote their independence.

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Achieving economic wellbeing

The home is a detached domestic house with an enclosed garden area to the rear. The garden provides a play area with suitable play equipment for the young people. The home environment is comfortably furnished and is well-maintained. Although the home is in very good decorative order, some of the rooms, including the hallway and lounges, lack wall decoration. This means these rooms are not as welcoming as others. The manager confirms arrangements are in hand for this to be improved.

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Organisation

The organisation is satisfactory. The Statement of Purpose reflects what the home offers; this includes full staff information. Written and pictorial information is available to young people, which describes the routines and care given at the home. 7 of 9 Inspection Report: SC389823 The promotion of equality and diversity is good. The home has a commitment to improve equality and diversity, which includes staff training. Staff ensure young people have access to services that support their education and promote health. Disability is not seen as a barrier in providing young people with experiences available to others.

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Organisation

Young people are looked after by a staff team who present as enthusiastic and caring in their work. Staff have opportunities to undertake training to increase their skills and competencies in their work with the young people. This includes training in respect of autism and equality and diversity.

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Organisation

There are appropriate staffing levels in the home to supervise and take account of the young people's known needs. The management team provides supervision to staff, so that they are properly supported in their work with the young people. Staff speak positively about the level of support they receive.

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Organisation

The manager of this home is also the manager of another of the provider's homes. The recent appointment of a house leader means a member of the management team is available in the absence of the manager.

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Organisation

Some of the staff have yet to obtain a relevant childcare qualification to help them in their understanding of caring for the young people. However, there is an ongoing programme of training for staff to enable them to obtain the appropriate National Vocational Qualification at level 3. To support young people under eight years of age, the home employs a suitably qualified nursery nurse.

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Organisation

There are systems of management and monitoring to ensure the home is running in accordance with its Statement of Purpose. However, management monitoring of the home has not been wholly effective to ensure the best care for the young people. This relates to the lack of monitoring in respect of the use and suitability of the 'relaxation' room and sanctions given to young people. However, the manager has addressed these matters and confirms appropriate monitoring is now in place.

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Organisation

Young people's records are maintained and have information relating to their individual history and progress at 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

17 February 2010 keep an accurate record of all medication administered to any child (Regulation 21.2) 17 February 2010 ensure the use of restraint is not excessive or unreasonable (Regulation 17.1) 8 of 9 Inspection Report: SC389823 17 February 2010 ensure records show the effectiveness and consequences of the use of any sanction or physical restraint (Regulation 17.4) 17 February 2010 ensure by means of fire drills and practices at suitable intervals that persons working at the home and children accommodated are aware of the procedures in case of fire (Regulation 32.1) 17 February 2010 ensure effective monitoring of the home's records in relation to the measures of control and discipline used in the home. (Regulation 34.1)

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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 hot water accessible to children is maintained at no more than 43˚C (NMS 25.8) • maintain a pleasant and welcoming environment in the home, in particular that the hallway and lounges have a more homely appearance (NMS 24.2) • ensure a minimum of 80% of care staff have the appropriate National Vocational Qualification at level 3 care award or equivalent qualification. (NMS 29.5) 9 of 9 Inspection Report: SC389823

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