Children's Home run by BREAK in Norfolk

SC060743 Unique reference number 24 July 2009 Inspection date Jan Davies Inspector Key Type of Inspection

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18 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 8 Inspection Report: SC060743

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Brief description of the service

The home is owned by a registered charity that owns a number of other children's homes and a residential family centre in the county. The charity also offers a residential respite care service for young people and adults with physical and/or learning disabilities. The home provides long-term accommodation for four young people, of either gender. They can stay at the home until they reach 18 years of age; the maximum age difference between the young people accommodated must be no more than five years. The young people living at the home might present some challenges to others. The home is well staffed 24 hours a day, the care staff group having a good gender balance.

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Brief description of the service

The home is a six-bedroom, three-storey house rented from a local Housing Association and it is in a small service road running parallel to the main road, adding to the safety of the location. The home is situated in a seaside town and only a few miles from a busy holiday centre with all its additional attractions and amenities. It is indistinguishable from others in the area and there is some limited car parking.

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Summary

This was an unannounced full inspection where all key National Minimum Standards were reviewed. Judgements have been made under each outcome area and the overall judgement is good. Young people are cared for by experienced and well-trained staff and young people's health is well supported. Young people's individual needs are identified and reflected into placement plans although there is a delay in obtaining all relevant information following statutory reviews. Education and leisure is well promoted, young people are consulted about their individual care and also about day-to-day living within the home and there are appropriate systems in place to safeguard young people and to promote their general welfare. Some areas for improvement are identified about recording of sanctions and significant fire safety work started but not fully completed. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The registered provider has fully addressed the shortfalls identified when the service was last inspected. The developments have led to improved placement plans and records of disciplinary interventions which include young people's signatures, accurately recorded doses of non-prescribed medication and comprehensive pathway plans for young people specifying appropriate support for them.

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Helping children to be healthy

The provision is good. The home makes opportunities for young people to plan and prepare meals. Discussions take place over the meal table around planning meals that are young people's choice. Young people enjoy a variety of dishes that reflect their diversity and preferences. Foods are stored safely and staff maintain records of fridge and freezer temperatures on a daily basis. 4 of 8 Inspection Report: SC060743 The home has written guidance on promoting good health and young people have their individual health care needs met through staff's adherence to the home's policy, and through appropriate appointments with health professionals that staff arrange for them. Staff maintain records of all medication administered and have attended recent medication training. First aid boxes are provided and staff in charge of duty shifts have valid first aid qualifications. Staff have access to an appropriate medication policy, and another policy containing a list for 'household' remedies.

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Helping children to be healthy

However the 'household' remedy policy is lengthy and not authorised by a medical practitioner. The registered person has not secured medical or nursing advice in a written protocol on the provision of non-prescription 'household' medicines to young people.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. The home makes appropriate arrangements to safeguard young people. Staff are sensitive to the needs of young people and respect their privacy and confidentiality. Young people are able to access their files and staff are proactive in their attitude to complaints encouraging young people appropriately to initially discuss concerns and then, if not resolved at that stage, to make formal complaint. Complaint forms are available to young people and young people say they are also able to discuss issues as they occur with staff members. The home provides a family type atmosphere where staff and young people eat together daily and discuss concerns and young people say that they are 'listened to'.

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Protecting children from harm or neglect and helping them stay safe

Staff receive child protection training and the home has effective child protection policies and procedures, which outline the appropriate response to allegations. Additionally safeguarding issues form part of staff induction. Staff are aware, that in the event of an allegation, to refer to the home's child protection procedure. An appropriate response is made to any serious incidents relating to a young person’s safety. This includes informing all relevant persons and taking any necessary action.

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Protecting children from harm or neglect and helping them stay safe

There have been no unauthorised absences since the last inspection but staff are aware of how to manage these should they occur including notifying the police and social services. Staff have a close professional relationship with young people and ring them to check their whereabouts or young people 'ring in'. Staff work positively with young people to manage their challenging behaviour and restraint is only used as an intervention to prevent an escalation of a challenging situation that could put everyone at risk. Young people respond well to the caring and structured environment. The recording of restraints are appropriate and young people feel sanctions are annoying, but fair. Incidents of disciplinary measures and interventions are all recorded. However the sanction book does not always record the duration of a restraint and contains entries that have been altered by use of tippex despite the manager's direction to staff not to do this.

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Protecting children from harm or neglect and helping them stay safe

The home maintains a visitor's book and young people generally live in a home where the necessary checks are made to provide a safe environment. The recruitment and vetting of staff is comprehensive and meets with regulations. Staff receive health and safety training and guidance from a range of procedures and the home has risk assessments for the premises, fire safety and individual young people. However, at the time of the inspection, fire doors were being 'propped open', the kitchen door was not fire safe and the county fire department had visited and issued an enforcement notice. This is because internal doors do not conform to fire regulations and fire safety in the home is not sufficiently robust. Currently young people are not fully protected by living in a home that fully provides physical safety. However the county 5 of 8 Inspection Report: SC060743 fire department acknowledged that the required work to make the building safe was in progress

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Protecting children from harm or neglect and helping them stay safe

and had given the home until September 2009 to complete work that has been started to the doors before the enforcement notice becomes effective.

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Helping children achieve well and enjoy what they do

The provision is good. There is a very good strategy in place in the home to ensure that a key worker is assigned for each young person to give support in line with their needs and wishes. Young people confirm they can also approach any members of staff and that they are listened to. Staff encourage young people to reach their potential and develop their talents for example to undertake charity challenges and compete and achieve in skills challenges for example, doing the Snowdon challenge recently. Young people also put on talent shows which include young people and staff working together on a production.

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Helping children achieve well and enjoy what they do

Young people are fully assisted to have their individual needs met. These include being provided to have special interests developed appropriately for example doing a photography project in conjunction with the local university and making and directing a video of special dance arrangements composed with help from staff. Other activities that staff promote for young people in the home include karaoke, singing, cooking and horse riding.

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Helping children achieve well and enjoy what they do

Staff fully support young people with their educational attainments. Currently all young people are in formal education or joining a college course in the Autumn and they are provided with appropriate facilities that are conducive to their study. The home provides a quiet room for young people to study in addition to space within their individual bedrooms. Staff support young people with homework. The home provides computers for young people to use for educational and recreational purpose and is proactive in obtaining information and advice around their use if asked.

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Helping children make a positive contribution

The provision is satisfactory. Each young person has an individual placement plan. The placement plans set out the assessed needs of young people and the objectives of the placement. Young people's designated key workers monitor the placement plans. Young people are encouraged to get involved in their review process. Young people and their family members attend review meetings and contribute to these where appropriate. However not all information from recent statutory reviews were available and not all care plans were informed by up to date review decisions which may lead to staff not being fully aware of the arrangements for an individual young person's care.

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Helping children make a positive contribution

Staff encourage young people to maintain relationships with their family members where appropriate. Key workers liaise with family members and pass significant information on to them where appropriate. Young people can receive their visitors in private and relationships with family and significant others is promoted.

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Helping children make a positive contribution

There are good consultation systems in place. For example, young people are consulted during regular house meetings and staff maintain good communication links with young people's families and their placing authorities. Information regarding access to advocacy service is provided to young people. 6 of 8 Inspection Report: SC060743

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Achieving economic wellbeing

The provision is good. Pathway plans are in place for all young people and these specify how they receive support with practical skills, alongside receiving individual care to support them into adulthood and develop a positive identity. The home raises young people's awareness of difference and social prejudice and developing coping strategies and promotes the importance of maintaining good community relationships and getting on with neighbours. There is a strong commitment to making young people independent and this occurs before the placing authority has started to draw up a pathway plan.

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Achieving economic wellbeing

The building is a double fronted detached property with a drive, parking to the rear and a small garden and blends easily into the surrounding properties, presenting as a large family home. Young people live in a residential area near the sea and the accommodation is domestic in style, homely, well furnished, clean, spacious, modern and comfortable. There is a large kitchen breakfast area that young people enjoy cooking in at times with help from staff.

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Achieving economic wellbeing

Young people have their own bedrooms, which they personalise to reflect their hobbies and interests, an example being their favourite football team. They have a choice of two communal lounge areas and a dining room that is also used for leisure interests. Facilities include a television with a wide range of channels, DVD player, mini music system and PlayStations. Young people are encouraged to cook and plan meals including meals from different cultural origins. Their daily routines include preparing meals, doing their own laundry, household chores and ironing and young people routinely learn skills, such as shopping, paying bills, following budgets and money management. Young people have their own bank account and receive encouragement to save.

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Organisation

The organisation is good. The service is managed by a registered manager and in their absence an experienced and well qualified deputy manager is available to cover. They are supported by a suitably experienced and knowledgeable staff group, a mix of both male and female staff. Several of the staff team have worked at the home for several years providing consistency for young people. Staff are available in adequate numbers to support the needs of the young people using the service.

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Organisation

The promotion of equality and diversity is satisfactory. Young people's needs, including those of culture and identity, are recorded and addressed to reflect their individuality. For example young people having access to staff who are able to promote a specific talent or interest through positive discrimination. Placement planning for individual young people sets out identified needs relating to areas of background and religion and they are supported to widen their knowledge and understanding of individual needs within society relating to equality and diversity. Young people's understanding of equality is supported by staff responding appropriately and raising young people's awareness to difference.

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Organisation

Training for staff includes regular up dates in behaviour management, fire safety, food hygiene, manual handling, risk assessments and safeguarding young people. All staff receive one-to-one supervision on a monthly basis and undertake an appropriate induction programme. 7 of 8 Inspection Report: SC060743 Young people have individual files which are well maintained, secure and contain previous and current information. Daily recordings are made and include any relevant events or behaviours experienced by young people. The care provided to young people is monitored by the manager and the responsible individual appropriately. Records are checked regularly and action is taken when an area for improvement is identified.

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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

25 September 2009 ensure there are adequate arrangements for detecting, containing and extinguishing fires; this refers to providing fire doors in the home as directed by the fire department [Regulation 32 (1) (c ) (i) and (d)] 4 September 2009 ensure that within 24 hours of the use of any measure of control, restraint or discipline a written record is made in a volume kept for the purpose; this refers to erasing the original record with tippex [Regulation 17 (4) (d)]

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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 qualified medical or nursing advice is sought for a written protocol on the provision of non-prescription 'household' medicines to children (NMS 13.11) • ensure the result of all statutory reviews of placement plans are recorded on the child's file; this refers to the lack of review decisions on a young person's file (NMS 3.4). 8 of 8 Inspection Report: SC060743

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