Children's Home run by Nottingham City Council in Nottingham

SC034969 Unique reference number 28 May 2009 Inspection date Katarina Djordjevic Inspector Key Type of Inspection

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14 October 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: SC034969

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Brief description of the service

The home is registered to care for six boys and girls aged between 10 and 18 years with emotional and behavioural difficulties and has one emergency bed. The aim of the home is to provide settled care as an alternative for young people who cannot remain within the family, but for them to return as soon as possible. The home aims to provide a safe and caring environment for vulnerable young people who may display challenging behaviours.

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Brief description of the service

The home is situated north of the city centre in a residential area. Local facilities include schools, shops and a GP practice. The building comprises of three houses converted into one. Bedrooms are single with adjacent bathrooms and toilet facilities. There are two office areas, lounge, dining area, family room and kitchen.

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Brief description of the service

There are currently five young people living at the home and two were present during the inspection.

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Summary

This was a key unannounced inspection. The purpose of the visit is to assess the quality of care provided for young people, in line with statutory requirements, and to check progress made on the action raised in the interim inspection report for 14/10/2008. All key standards were inspected and standards 15, 20, 21, 28 and 33 were also inspected.

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Summary

This is a satisfactory service with some good aspects. Relationships between young people and staff are based on respect which helps young people enjoy, achieve and make positive contributions in their lives. Young people feel safe living at the home and there are various systems to enable young people to raise any concerns they may have. This helps to protect young people from the risk of harm and abuse. Care records are of a good standard which helps staff ensure they are able to meet young people's needs. Medication practices are not in line with current guidance and have the potential to pose a risk of harm to young people. Safe recruitment practices are followed. However, the home does not always have documentary evidence to support that agency staff used have had the required recruitment checks.

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Summary

The home is currently undergoing some significant staffing changes with the registered manager and a small number of the current staff team due to leave in the next couple of months. The local authority is in the process of re-organising their children's residential services which has resulted in one children's home closing. The management team and staff from the home that has closed are joining this home's existing team. Whilst there is no evidence that theses changes have impacted on the quality of care provided to young people, these changes have the potential to affect the consistency of care provided. Clear strategies are needed to ensure these staff changes do not affect the care and support given to young people. 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

At the last inspection the registered manager was asked to ensure that all young people had an up-to-date placement plan. This has been addressed although when placement plans are reviewed and changes made, the date is not always included. 4 of 10 Inspection Report: SC034969

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Helping children to be healthy

The provision is satisfactory. Procedures are in place to ensure that medicines are appropriately handled and stored to safeguard young people's welfare. Each young person has a medication record for prescribed medication. However, recording of medication in some instances is not in line with the Royal Pharmaceutical Society of Great Britain's guidance 'The handling of medicines in social care' guidelines. For example, the medication record does not give the dosage and frequency of medication prescribed and does not always record why medication has not been given. There is no record of medication being taken out of the home, for example, when a young person goes on holiday. A record of medication that has been disposed of is not always kept. Staff have not received appropriate training in the handling and administration of medicines.

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Helping children to be healthy

Young people receive a varied and well-balanced diet. Staff work hard with young people to encourage healthy eating. There is a four-week rotating menu which includes two options for the main meal, one of which is a vegetarian meal and young people have a takeaway once a week. Records are kept of alternative meals provided. The food is home cooked with fresh ingredients and fresh fruit is readily available for young people to help themselves. The kitchen is currently being refurbished and alternative arrangements have been made to provide meals for young people.

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Helping children to be healthy

The promotion of young people's health is taken seriously by the home. Staff are committed to meeting young people's health needs and promote a healthy lifestyle ensuring their needs are being met. Young people feel they are well supported with their health needs. Care records give clear details of health needs and what actions to take to meet them. Staff support young people to access different health advisory and support services to ensure their physical and emotional needs are met. Staff also work closely with other agencies such as drug and alcohol dependency services to ensure that young people receive the appropriate advice, support and where necessary, treatment. There is plenty of information on display for young people to access regarding smoking and sexual health matters.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Young people feel safe living at the home and are well supported by staff. Staff are skilled and experienced in assessing any risks which may result in harm or abuse to young people living at the home. Young people are supported to take controlled risks in preparation for adulthood. Staff work closely with other agencies to promote the protection and well-being of young people.

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Protecting children from harm or neglect and helping them stay safe

There are clear procedures for the recruitment of staff and safe recruitment practices help to protect young people from the risk of harm. However, the home does not always have documentary evidence that agency staff used have received checks in line with Schedule 2 of the Children's Homes Regulations 2001.

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Protecting children from harm or neglect and helping them stay safe

The management of health and safety at the home is good which helps to protect young people from the risk of harm and injury. Equipment and installations are serviced as required. Regular checks of the fire alarm system are carried out and the fire evacuation procedure is explained to each young person on the day of admission. Staff receive fire safety training but it is unclear 5 of 10 Inspection Report: SC034969 if this meets the requirements of the Fire Authority. Environmental risk assessments are in place and are reviewed when necessary.

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Protecting children from harm or neglect and helping them stay safe

Young people are treated with dignity and respect. This increases their self-esteem and helps them to learn to value and respect others. Young people are given keys to their bedrooms and staff knock on their bedroom doors before entering. Records are kept securely.

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Protecting children from harm or neglect and helping them stay safe

Young people know how to complain and there is plenty of information which is easily accessible for young people to contact other agencies. The young people's 'Welcome booklet' contains details of the complaints procedure including contact details of Ofsted and other useful organisations. Young people say their concerns are listened to and acted upon quickly. Records of complaints received are kept and give details of the nature of the complaint, actions taken and the outcome. The record does not always state if the complainant is satisfied with the outcome. Records confirm that complaints are dealt with quickly and appropriately.

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Protecting children from harm or neglect and helping them stay safe

The home has clear child protection policies and procedures and also has a copy of the Local Safeguarding Children's Board (LSCB) procedures. Staff receive child protection training as part of their induction and any issues relating to child protection procedures are discussed in staff meetings. All significant events relating to the protection of young people at the home are notified to the relevant agencies, which helps to protect young people.

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Protecting children from harm or neglect and helping them stay safe

The home keeps an anti-bullying file which contains the policy, associated guidance and other information such as the 'Beat Bullying' document. Young people have a 'protection plan' where there is an identified risk of bullying. The protection plans give very clear strategies to staff how to support and protect a young person from bullying. Staff discuss with the young person accused of bullying, their behaviour, make it clear it is not acceptable and also discuss the possible consequences of the behaviour.

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Protecting children from harm or neglect and helping them stay safe

Clear procedures and practices to deal with unauthorised absence help to protect young people from the risk of harm and abuse. There is a joint protocol with the Police for young people who go missing. Relevant agencies are informed and records kept as required. A record of return discussion is kept where staff check that no harm has come to a young person during the period of absence and discuss reasons for absconding. The record is also used to monitor the numbers of unauthorised absences which may trigger a child protection referral or a meeting being held with relevant agencies.

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Protecting children from harm or neglect and helping them stay safe

Staff are skilled in managing young people's behaviour where the emphasis is placed on rewarding positive behaviour. Staff support and encourage young people to develop socially acceptable behaviour and to take on responsibility for their actions. This helps to increase young people's self-confidence, prepares them for adulthood and being part of the wider community. Restraint has not been used since 2007 which is testament to the skills of the staff team. There is a list of agreed and prohibitive sanctions on the young people's noticeboard in the dining room. This ensures young people are clear about what they can expect. Sanctions are fair and proportionate. Appropriate records of restraints and sanctions are kept.

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive a good level of care based on their assessed needs. Staff have an in depth knowledge of young people's needs which helps to protect young people from the risk of harm 6 of 10 Inspection Report: SC034969 and promote their wellbeing. Positive relationships exist between young people and staff which helps young people to feel valued, develop their self-confidence and develop skills in preparation for adulthood. Staff work closely with a range of other agencies to ensure young people's needs are being met. Staffing levels are based on identified needs and are flexible. Young people's educational achievements and leisure interests are well supported enabling them to achieve their potential in learning and social skills.

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Helping children achieve well and enjoy what they do

Equality and diversity issues are addressed. The organisation demonstrates that their recruitment and selection policies and procedures promote equality of opportunity well. Staffing arrangements take into account young people's ethnic and cultural backgrounds. Staff receive training in the promotion of equality and diversity. Staff are proactive in meeting different cultural needs which involves working with different outside agencies in relation to seeking advice about religious, cultural, sexuality and gender issues.

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Helping children achieve well and enjoy what they do

Education is seen as important by staff at the home and young people are encouraged and supported to achieve their potential academically. This involves working closely with the local authority's education services. Staff work hard with local schools and colleges to ensure young people can continue their education with as little disruption as possible. Young people are supported with their homework and revising for examinations. Young people are actively encouraged to move onto further education. Young people's files contain Personal Education Plans, school reports and certificates of achievements.

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Helping children achieve well and enjoy what they do

Young people are provided with a range of leisure activities based on their interests, hobbies and needs. These take into account any cultural needs. Young people also go on holidays with staff from the home.

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Helping children make a positive contribution

The provision is good. Young people are actively encouraged and supported to make positive contributions to their daily lives which enables them to build up their confidence and self-esteem.

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Helping children make a positive contribution

All young people have individual files which contain background and referral information, care plans, risk assessments and case records. Care plans which cover all five areas under Every Child Matters are of a good standard and give clear details of needs and how to meet them. Care plans are not always signed by young people. Care plans and risk assessments are reviewed regularly, although, in some instances the date when the document was reviewed is not clearly recorded.

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Helping children make a positive contribution

Review meetings are held as required and minutes of these meetings are kept on file. Staff at the home prepare progress reports for the statutory reviews. Young people attend their review meetings and are supported by staff to complete a form for the review with their views about the care they are receiving and their future.

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Helping children make a positive contribution

Contact arrangements are clearly recorded to ensure that staff understand each young person's situation with regards to meeting with their family. Staff work hard to support young people to maintain valued relationships with family through appropriate contact arrangements.

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Helping children make a positive contribution

The majority of young people admitted to the home since the last inspection have been on an emergency basis. Staff try to ensure young people are given appropriate support when moving 7 of 10 Inspection Report: SC034969 in. Young people are given the 'welcome booklet' either prior to admission or on the day of admission. This gives good information about what life is like at the home, what the young person can expect and what is expected of them. A member of staff also spends time helping the young person settle in, which includes going through the routines of the home and some basic health and safety procedures such as the fire safety evacuation procedure. Young people are actively encouraged to bring their personal possessions with them and personalise their bedroom.

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Helping children make a positive contribution

Young people are encouraged and supported to make decisions about their lives and to influence the way the home is run. Weekly residents' meetings are held where young people are able to express their views and put forward suggestions about the running of the home. Regular key worker sessions are held and records kept. These sessions not only give the young people the opportunity to discuss their views about their futures but are also used to discuss issues around keeping themselves safe and healthy.

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Achieving economic wellbeing

The provision is satisfactory. Young people are encouraged to be involved in the planning, shopping and cooking of meals which helps them to develop independence skills. They are also supported to clean their own rooms and do their own laundry. Pathway Plans are in place for those young people of the relevant age and staff work closely with the Leaving Care team and other agencies such as Connexions.

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Achieving economic wellbeing

Some areas of the home are decorated and maintained to a satisfactory standard. However, the decoration in the dining room and main lounge is poor and the gardens are overgrown which stops young people from using them. The kitchen is currently being refurbished. All young people have their own bedrooms which they are encouraged to personalise. There are sufficient toilets and bathrooms, all of which have privacy locks fitted.

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Organisation

The organisation is satisfactory. This is a well managed home with an experienced and committed staff team where young people receive a good level of care. As a result young people feel safe, valued and supported. However, the staff team is going through a period of change due to the reorganisation of the local authority's children's residential services. The registered manager is leaving along with a small number of staff. The management and staff team from another home, which has recently closed, are in the process of joining the existing staff team. Although there is no evidence that these changes have impacted on the provision of care for young people, such changes do have the potential to affect the consistency of care provided.

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Organisation

There are effective internal monitoring systems which help to identify shortfalls in practice and improve the quality of care provided to young people. In addition to the day-to-day monitoring of records and practices by the management team, the registered manager carries out monthly audits as required by Regulation 34 of the Children's Homes Regulations 2001. Regulation 33 visits are carried out monthly and reports produced. However, the visits do not cover all the required areas regularly. For example, complaints are looked at twice a year as opposed to monthly. 8 of 10 Inspection Report: SC034969 The home's Statement of Purpose has all the information required in Schedule 1 of the Children's Homes Regulations 2001 although some information is out of date. This informs young people, their families and placing authorities about the services provided at the home. Young people are given a 'welcome booklet' which gives them information about what to expect and what is

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Organisation

The promotion of equality and diversity is good. Care provided is based on individual assessed needs taking into account racial, religious, cultural, and linguistic backgrounds and needs. Staffing arrangements also take into account ethnic and cultural backgrounds as well as gender issues.

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Organisation

Staff receive regular supervision and are well supported by members of the home's management team. Handovers take place between each shift ensuring staff are kept up-to-date with events and the changing needs of the young people. Staff receive training in child protection, fire safety, behaviour management, basic first aid and basic food hygiene as part of their induction 'Preparing to Care'. On completion of the induction staff enrol on the National Vocational Qualification (NVQ) Level 3 in Caring for Children and Young People. 80% of the staff team currently have the NVQ 3. Regular refresher training is provided. However, the staff training records are not kept up to date which makes it difficult to assess what training staff have received during the last year.

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Organisation

Young people's files contain all the necessary information as detailed in Schedule 3 of the Children's Homes Regulations 2001, to inform staff about the needs of young people and how to meet their needs.

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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

5 July 2009 make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received in line with the Royal Pharmaceutical Society of Great Britain's guidance 'The handling of medicines in social care' guidelines (Regulation 21 (1)) 5 July 2009 provide staff with appropriate training in the management of medicines (Regulation 27 (4) (a)) 5 July 2009 provide documentary evidence that all agency staff used have had appropriate recruitment checks as detailed in Schedule 2 and that they have received mandatory training (Regulation 26 (3)) 5 July 2009 ensure all areas of the home are kept reasonably decorated and maintained including the gardens (Regulation 31 (2) (e)) 9 of 10 Inspection Report: SC034969 5 July 2009 ensure the Regulation 33 visitor covers all areas as required with particular reference to looking at the record of complaints (Regulation 33 (4))

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Due date Action Standard

31 July 2009 ensure the information in the home's Statement of Purpose is up-to-date.(Regulation 5)

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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): • record in the complaints record if a complainant is satisfied with the outcome of the investigation (NMS 16) • consult with the Fire Authority regarding the required frequency of fire safety training for staff to ensure compliance with the Fire Authority's Regulations (NMS 26) • ensure young people are given the opportunity to sign their care plans (NMS 2) • ensure when care plans are reviewed and updated that the date is clearly recorded (NMS 2) • ensure the staff training records are kept up-to-date. (NMS 31) 10 of 10 Inspection Report: SC034969

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