Children's Home run by Destiny House in Harrow

SC038906 Unique reference number 29 July 2009 Inspection date Karen Malcolm / Angela Hunt Inspector Key Type of Inspection

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23 February 2009 Date of last inspection .

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 10 Inspection Report: SC038906

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Brief description of the service

This children's home is privately run. The Registered Manager is also the named Registered Provider. The home provides care and support for up to eight children or young people of either sex aged from 13 to under 18 years. The home is situated on a busy main road close to local shops and transport. The house is an extended semi-detached building on two floors. There is one double room and two single rooms on the ground floor. In addition to this there is a double and three single rooms on the first floor. There are shower rooms on each floor. The laundry is situated on the ground floor. There is a large kitchen and spacious dining/lounge area. There is off street parking to the front of the house for several cars. There is a large, rear garden with a small indoor swimming pool but this is not in use.

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Brief description of the service

The home has security surveillance equipment positioned outside and within some of the communal areas of the home.

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Summary

This unannounced key inspection looked at the progress the setting has made with the requirements and recommendations made at the last inspection. All the key standards were also inspected.

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Summary

The overall judgement following this inspection is inadequate - notice to improve. This inspection identified shortfalls in the outcome areas Staying Safe and mainly Organisation. Areas of concerns relate to insufficient evidence that the home is adequately staffed at all times and this is reflected on the rotas in place. There was no evidence that monthly monitoring visits are carried out; menu plans, care plans, risk assessments and quality assurance assessments are not being consistently monitored and reviewed regularly by the Registered Person. The other outcome groups were deemed either good or satisfactory. Generally the home functions well and young people spoken to are happy with the service being provided. The overall quality rating is inadequate. 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 one action was made and no recommendations. The Registered Person was asked to ensure that young people’s care plans are updated accordingly, ensuring all known areas of risk, especially pertaining to behaviour, are addressed. This was fully addressed prior to the inspection as a copy of the young person's risk assessment was sent to Ofsted.

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Helping children to be healthy

The provision is satisfactory. The kitchen area is deemed the focal point of the home. The home provides young people with a four week rolling menu plan which can be changed. Staff and young people spoken to said that the menu is changed regularly to meet the various needs and changeable choices. The consequence of this is that meals such as take-away, freezer food days and Sunday roast or any changes are not updated or recorded on the current menu plan. Young people who require a special or culturally specific diet do have their needs met, however, since the menu plan is changed constantly this is also not clearly recorded. Young people spoken to said that the 4 of 10 Inspection Report: SC038906 meals provided are very good. However, they are never sure of what is on the menu but this is always a nice surprise.

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Helping children to be healthy

All young people are registered with a local surgery, dentist and optician. Young people routinely undertake medicals and attend appointments. Young people receive support from counselling and therapeutic services. Young people have regular opportunities to discuss their feelings with staff. Staff closely monitor young people's health and appropriately refer to the necessary health professionals. Since the last inspection the home is supporting young people with mild learning difficulties. However, there is no clear evidence that staff are fully able to support young people with this need appropriately.

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Helping children to be healthy

The medication policy now includes clear timescales when non-prescribed medication can be administered to young people safely. This was updated by the Registered Manager at the time of this inspection. There is also a loose list of homely remedies that can be used by the home, but this list is not included in the medication policy. The home securely stores all medication in a purpose built cabinet and there is also a separate cold store if needed. At present none of the young people are on prescribed medication. Young people generally benefit from good health care arrangements.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. The home has electronic surveillance in place. There are eight cameras in total around the exterior parameters of the building as well as the communal areas. The home's surveillance policy indicates that the primary reason for surveillance monitoring is to reduce the criminal behaviour of young people. Young people spoken to confirmed they had signed an agreement relating to surveillance equipment and they were happy knowing the devices were in place. Risk assessments make mention to surveillance enhancing both the safety and security of young people and the staff. While the home's written surveillance policy complies with the requirements of Regulation 22, it has not been fully implemented in practice. For example, while there is evidence in support of the child's placing authority consenting to the use of this measure there is no reference to the use of surveillance in individual placement plans. The shortfall in fully

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Protecting children from harm or neglect and helping them stay safe

complying with Regulation 22 compromises the privacy of young people.

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Protecting children from harm or neglect and helping them stay safe

Young people all have single occupancy bedrooms which have appropriate access. The living arrangements provide space where they can relax and easily find privacy away from others if they wish. Staff are sensitive to gender issues especially when dealing with young people of the opposite sex. Staff know how to deal with and share information which they are given in confidence for child protection purposes. All sensitive and personal data held in the home is now fully protected as during the inspection the Registered Manager registered with the Data Protection Body.

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Protecting children from harm or neglect and helping them stay safe

Young people are given guidance and support on how to complain. Any complaint is addressed without delay and the complainant is kept informed of progress.

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Protecting children from harm or neglect and helping them stay safe

The safety and rights of both staff and young people are protected. There are clear procedures in line with the Regulations which are known, understood and followed by all staff, for responding to allegations or suspicions of abuse, either by staff or by other young people in the home. Staff are familiar with the home's own safeguarding procedures. Most staff have 5 of 10 Inspection Report: SC038906 received some basic child protection training which forms part of the home's core staff training programme.

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Protecting children from harm or neglect and helping them stay safe

There are appropriate policies, procedures, records, and consistent working practices that underpin this work of ensuring absences without authority are appropriately managed. The home liaises with police and the placing authority when young people are missing from the home. Where there is a continued absence from school, or a worrying pattern of absence, the registered person initiates a review of the placement plan with the placing authority on the best steps forward to safeguard the young person in their care. Evidence show that approximately 50% of the young people were absent without authority at the time of this visit. Although contact had been made with each individual, they remained reported as missing from the home and to the appropriate authorities until their return.

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Protecting children from harm or neglect and helping them stay safe

Young people have no concerns about bullying and confirm that staff are quick to intervene should a situation arise. The ethos of the home is to create a atmosphere where bullying is known to be unacceptable.

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Protecting children from harm or neglect and helping them stay safe

Young people are assisted to develop socially acceptable behaviour through encouragement of acceptable behaviour and constructive staff response to inappropriate behaviour. Sanctions are imposed if behaviour is deemed unacceptable. However, all sanctions recorded have monetary actions imposed. Young people’s pocket money is withheld and placed into a savings account and given back when the young person leaves the home. Staff feel such measures given are fair and effective. However, the sanctions behaviour patterns recorded are persistent and the same sanction is then applied. Behavioural risk assessments are updated monthly along with the monthly care plan update. Training in positive handling techniques has been undertaken by all staff.

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Protecting children from harm or neglect and helping them stay safe

Baths, showers and toilets are of a number and standard to meet the needs of the young people. All have appropriate locks for the privacy and safety of each young person.

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Protecting children from harm or neglect and helping them stay safe

General health and safety issues are addressed with a range of risk assessments in place including specific individual risk assessments. However, young people do not seem to be fully aware or need constant reminding to not overload the electrical multi-plug adapters, which can be hazard if not used correctly. Appropriate service contracts are in place for fire, gas and electrical equipment. However, annual checks for Legionnella test was found to be incomplete.

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Protecting children from harm or neglect and helping them stay safe

There have been a number of staff changes in the home; however, the staff employed have worked for the organisation for many years across the Organisation. Appropriate recruitment practices are in place and all staff working at the home have received an appropriate Criminal Records Bureau (CRB) check. However, information such as proof of identity and a full employment history were missing from the files examined.

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Protecting children from harm or neglect and helping them stay safe

A record of all visitors to the home is in place.

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Helping children achieve well and enjoy what they do

The provision is good. Young people acknowledge they receive good support from staff giving their key worker as an example. Practical individual support is reflected in the records of key worker sessions along with the variety of planning documentation that is in place. Young people receive individual 6 of 10 Inspection Report: SC038906 support when they need it, and this may include support around personal issues, health, sex and relationship, education and getting on with other young people in the home. Young people spoken to said that they feel they are trusted by the staff team which they did not have in their other placement.

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Helping children achieve well and enjoy what they do

Specific educational arrangements are in place for each young person. Each young person’s file contains a copy of their Personal Education Plan (PEP) setting out a record of their educational achievements, needs and aspirations. Young people are encouraged to achieve their best through education by staff, and any other additional support is put in place to help the individual to achieve this. The majority of the young people placed are new to the home and therefore information on their educational needs is brief or not in place. All bedrooms are equipped to allow for private study. Those young people with special educational needs have appropriate support in place and this may include cultural, religious or additional educational support.

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Helping children achieve well and enjoy what they do

Young people are able to pursue their particular interests, develop confidence in their skills and are supported and encouraged by staff to engage in leisure activities. There is allocated financial resources to fund leisure activities and trips out.

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Helping children make a positive contribution

The provision is satisfactory. The home uses the placing authority's placement plans. In addition, regular key worker sessions and a detailed monthly report for each young person is completed by staff. These are based on the information from reviews and their ongoing dialogue with the young person. Notwithstanding this, current placement plans in place are limited in detail and do not clearly set out each young person's assessed needs and objectives. This could impact on a child's needs being fully identified and met.

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Helping children make a positive contribution

Statutory reviews take place within the required timescale. Records of the meetings are held alongside reports prepared by staff prior to a review taking place. Collectively they provide evidence that details areas of progress. Young people are consulted by the placing authority at each review and this information is used as part of their overall assessment of care. Prior to the review key workers prepare the report and if a young person so wishes they can request additional support.

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Helping children make a positive contribution

Contact details and plans are in place for each young person. Some are complex due to individual circumstances. Plans detail the role of contact in promoting cultural identity and experiences.

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Helping children make a positive contribution

Young people are able to move into and leave the home in a planned and sensitive manner.

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Helping children make a positive contribution

Young people recognise that staff are supportive in helping and guiding them towards making positive decisions for themselves. The relationships between young people and staff are good. Young people are relaxed in the company of staff and are quick to approach them with any issues they may have. There is no clear system in place as to how the views of young people, parents and placing authorities are taken into account in the development of any necessary change in the operation of the home. The home relies on the feedback forms from young people’s reviews but this information is not kept by the home or used as part of the home's quality assessment review. 7 of 10 Inspection Report: SC038906

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Achieving economic wellbeing

The provision is satisfactory. Young people receive pocket money according to their age and ability. Clear accounts are kept. Young people are very aware of their rights. Young people are encouraged to manage their own finances through help with budgeting and are given as much freedom as possible in making decisions about spending their own pocket money. Cultural, racial, ethnic or religious expectations regarding the choice of clothes or personal requisites are supported and positively promoted.

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Achieving economic wellbeing

The home is a large, adequately furnished, comfortable house which is more than fit for its purpose for support of up to eight young people.

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Achieving economic wellbeing

Young people are encouraged to achieve their full potential and develop skills for adulthood, but at present none of the young people placed are at this stage.

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Organisation

The organisation is inadequate. The staffing level in the home was found to be inconsistently covered at all times. Past and current rotas demonstrated that some weekend shifts were inadequately staffed. Therefore, there was no clear evidence that young people were properly safeguarded during these periods. Staffing arrangements for staff sickness and absences were also not clearly demonstrated. The current staffing level is approximately six to eight staff which includes the manager, a deputy and a number of staff working part time. There is a core team of staff employed and available to cover vacant shifts and other absences when required. However, there was no evidence of this reflected on the rotas seen. The staff level is two staff on each of the day shifts and one member of staff sleeping-in. This is risk assessed and increased when the need arises such as planned activities or additional support needed for a young person. During July the number

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Organisation

of young people placed in the home increased from one to five. The manager said that she works each weekend to ensure adequate arrangements for cover are in place, but this was not reflected on the rotas seen. If the manager did undertake these duties, this would have meant the manager had worked seven days each week. All staff are aware of the management and on-call arrangements, but information regarding this was not displayed.

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Organisation

The staff group in day to day contact with young people includes staff of both genders, whenever possible, and the cultural make-up of the staff team is predominately Black Caribbean. The young people placed are of various cultures and when spoken to felt that they were supported appropriately.

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Organisation

Staff receive training and development opportunities that equip them with the skills required to meet the needs of the children. However, the current training programme does not highlight any training on working with children and young people who have Aspergers Syndrome or mild learning difficulties.

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Organisation

Over 80% of the staff team employed have gained qualifications to NVQ level 3 or above.

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Organisation

There are support systems in place for staff such as supervisions and team meetings. However, formal appraisals regarding reviewing individual's overall development needs are not regularly undertaken. 8 of 10 Inspection Report: SC038906 Young people spoken to said that they have received a copy of the Young People's guide as part of their induction to the home. They also said that they are aware of the all the services the home provides for them and especially the ground rules which they have agreed to and signed.

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Organisation

Monitoring visits regarding the welfare of the young people have not been undertaken. There is also no clear system in place to monitor all the areas under Schedule 6, such as accurate records of the daily menu plans, staff appraisals, the duty rosters of persons working in the home and the home's staffing levels.

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Organisation

Young people, their parents and the placing authorities are not regularly consulted by the home about their views or opinions. Verbal and written feedback is given, but there is no clear system in place to collate this information and share this with other stakeholders who may be interested.

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Organisation

The promotion of equality and diversity is satisfactory. Evidence supports an inconsistent commitment to improving equality and diversity in some practice. The outcomes for individual young people are acceptable and demonstrate care that generally meets individual needs, but there is no clear evidence of how this is monitored and reviewed, to ensure that young people's overall cultural and diversity needs are being met fully.

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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

30 September 2009 ensure that placement plans are sufficiently detailed so as to clearly indicate the assessed needs of the young person, the objectives and how these are to be met. (Regulation 12) 30 September 2009 ensure that a record is kept of menus served (Regulation 29) 10 30 September 2009 have clear timescales of when non-prescribed (homely remedies) medication can be administered to young people. (Regulation 21) 30 September 2009 ensure legionnella checks are carried out annually. (Regulation 23) 30 September 2009 ensure young people have the knowledge and understanding of how to use electrical multi-plug adaptors safely. (Regulation 23) 30 September 2009 ensure that CCTV is not used except for the purpose of safeguarding and promoting the welfare of a child or other children in the home, and that if deemed appropriate to use, it is provided for in the child’s placement plan. (Regulation 22) 31 August 2009 register with the Data Protection Body. (Regulation 23) 9

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Due date Action Standard

9 of 10 Inspection Report: SC038906 31 August 2009 ensure that staff employed at the children’s home have on file a full employment history and proof of identity including a recent photo. (Regulation 6, 8, 26 Schedule 2) 31 August 2009 ensure that all staff received appropriate, regular appraisals. Regulation 27(4) (a) 30 September 2009 review the staffing arrangements and the rota to ensure appropriate cover is in place at all times and this must be accurately reflected on the rota in place.(Regulation 29 & 34(1) Schedule 6) 30 September 2009 ensure that Regulation 33 visits are conducted a least once a month and that a copy of the report is kept in the home. (Regulation 33) 30 September 2009 establish and maintain a system for monitoring the matters set out in schedule 6 and which includes consultation with children accomodated in the home, their parents and placing authorities. (Regulation 34)

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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): • include in the medication policy, the homely remedies list of non–prescribed medication and treatments used by the home. (NMS 13) • explore with the staff team and agree practicable and acceptable means of responding to unacceptable behaviours that does not only impose monetary fines. (NMS 22) • ensure all staff undertake appropriate training to support young people with Aspergers Syndrome and learning difficulties. (NMS 31) 10 of 10 Inspection Report: SC038906

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