Children's Home run by Country Care Children’s Homes Ltd in Derbyshire

SC020151 Unique reference number 7 October 2009 Inspection date Stella Henderson Inspector Key Type of Inspection

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17 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 9 Inspection Report: SC020151

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Brief description of the service

The home provides therapeutic care, accommodation with education and outdoor activities for up to eight young people aged 10 to 17 years old. The home is situated in a rural location but within easy reach of essential services and amenities. There is also easy access to major towns and cities.

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Summary

The purpose of this visit was to follow up on requirements made at the last inspection and to undertake a key unannounced inspection. Six outcomes were inspected: being healthy, staying safe, enjoying and achieving, positive contribution, achieving economic wellbeing and organisation.

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Summary

Key national minimum standards (NMS) are generally met and the service has more strengths than weaknesses. Procedures are in place which make sure that young people are protected and kept safe from abuse. Staff make sure that health care needs are met so that the good health of young people is maintained. The provision of educational facilities is excellent.

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Summary

The staff team have experience as well as relevant training in how to care for young people. There is satisfactory management oversight into how the home is running, but a lack of robust quality assurance compromises the otherwise good quality of care young people receive. 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 provider was asked to make improvements in practice in respect of maintaining a record of complaints made by young people and in the use of physical restraint. Evidence from this inspection demonstrates that these actions have now been met. A third action was raised with regard to the disposal of medication. Although this has been met a discrepancy in the recording of medication was identified at this inspection for which a requirement has been made.

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Helping children to be healthy

The provision is satisfactory. Young people are provided with ample quantities of freshly prepared food and drink. The menu is varied with a very good choice of fruit, salad and vegetables. Young people are well nourished and one young person commented that 'the food is always good here'. Food intake for all young people is monitored which enables staff to identify any problems around diet, although there are some inconsistencies in the recording of what young people have actually consumed.

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Helping children to be healthy

Young people have an opportunity to prepare and cook meals which helps them to develop practical skills for future independent living. Young people do not have the opportunity to budget and purchase food however as a 'big shop' is undertaken by the provider each week.

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Helping children to be healthy

The good health and well-being of young people is effectively promoted. All young people are registered with primary health care services and specific health plans are compiled with respect 4 of 9 Inspection Report: SC020151 to their individual needs. The psychological and emotional health of young people is seen as a priority and young people have the benefit of access to an in-house psychologist. Art therapy and other therapeutic interventions are integrated into young people's care planning and one young person commented that therapy had been 'a massive help'.

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Helping children to be healthy

Staff actively encourage young people to live healthy lives and stop engaging in activities that may be harmful to their health. Support and advice is given on sexual health, illegal substances and alcohol use. Young people also have access to a range of outdoor activities which promotes physical exercise.

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Helping children to be healthy

The health of young people is safeguarded through regular monitoring of fridge and freezer temperatures as well as kitchen health and safety practices. All medication is safety stored in a locked cabinet to which young people have no access. Staff are trained in first aid and there is consent on file for medical interventions. There is inaccurate recording of the dispensing of certain medicines however, which means that the safety and well being of young people is compromised.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. The procedures and practices at the home respect young people's privacy and dignity. For example, information that is sensitive and confidential is stored appropriately and securely. Young people are able to have privacy when making telephone calls and arrangements for using the bathrooms ensure that the dignity of young people is not compromised.

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Protecting children from harm or neglect and helping them stay safe

Young people benefit from living in an environment that has a clear focus on keeping young people safe. There are effective arrangements in place to deal with absconding, bullying, complaints and safeguarding. Staff are skilled in behaviour management and provide effective guidance and support to those young people who need it.

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Protecting children from harm or neglect and helping them stay safe

There is close working with teaching staff and the psychologist on the best ways to manage behaviour and how to intervene. When behaviour does become unacceptable, or when young people put themselves at risk, staff are quick to respond and are effective in helping to resolve any difficulties.

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Protecting children from harm or neglect and helping them stay safe

Each young person has an individual behaviour management plan and sanctions, when imposed, are fair. Young people are encouraged to develop positive behaviours in a nurturing supportive manner through clear but kindly interventions and exemplary role modelling by staff.

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Protecting children from harm or neglect and helping them stay safe

Staff receive appropriate training on the use of physical restraint, however the recording of such interventions are not compliant with these regulations. It is not clear, for example, which member of staff carries out the restraint.

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Protecting children from harm or neglect and helping them stay safe

The management of health and safety processes is good which helps to protect young people from the risk of harm or injury. Equipment and installations are serviced as required and regular fire safety tests are carried out, including fire drills undertaken at night. Risk assessments are also in place to identify and reduce the risk of harm from young people's known or likely behaviours and environmental hazards. 5 of 9 Inspection Report: SC020151 Young people are protected because people working at the home are thoroughly checked before starting work there. Although all the information required by these regulations is in place, confusing information provided by prospective employees has not been clarified which undermines otherwise good practice in this area.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people receive excellent levels of individual support at the home. Staff provide good role models and use a range of interventions to raise young people's confidence, self esteem and social skills. Young people are offered care that is tailored to their particular needs, so each individual receives personal, social, psychological and emotional support and guidance that is appropriate to them. Support is also provided, where necessary, to help young people maintain their individual cultural and faith identity. This enables all young people at the home to feel valued and included.

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Helping children achieve well and enjoy what they do

Young people have full access to educational facilities in line with their individual needs. The home provides on-site education and the school was judged 'outstanding' at the last Ofsted inspection. Staff ensure that young people are up in time, properly dressed and equipped to attend on time every day. Young people wear a uniform and there is a clear physical distinction between the home and school. The school has excellent facilities and young people follow the usual curriculum with very good outcomes. One young person explained to the inspector that a lap top had been provided to help with examination work.

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Helping children achieve well and enjoy what they do

There are lots of books and board games available for young people to enjoy. The home also has a pool table and a small fishing lake. Cheer leading, piano lessons, horse riding and attending local youth clubs are some of the ways in which young people are helped to develop their talents and interests. This encourages young people to network and develop friendships in the local community, helping to 'normalise' their lives as well as providing the emotional benefits of acquiring new relationships.

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Helping children make a positive contribution

The provision is good. Each young person accommodated has a placement plan outlining the way in which the home will work to address their needs. Plans are comprehensive and individualised. They draw together information received from a number of different sources, such as referral documentation, statutory reviews and any psychological and educational assessment that may have been completed.

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Helping children make a positive contribution

Staff are well-informed about the diverse range of needs of the young people accommodated and implement different methods of working in recognition of these. Highly effective key working systems are in place but young people are aware that they can approach any member of the team for help, not just their key workers.

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Helping children make a positive contribution

The well-being and development of young people is reviewed on a regular basis by formal measures, such as statutory reviews, and by daily general observations and communication with staff. This means that any changes in behaviour or developmental need is quickly noticed and steps taken to respond to those changes. Detailed reports for statutory review meetings are provided and young people are encouraged to attend these meetings. 6 of 9 Inspection Report: SC020151 Contact with family and significant others is encouraged. Such arrangements are discussed at an early stage of the placement and are detailed in care plans. Any restrictions on contact are made clear and explained to the young person. This enables young people to maintain their links with family whilst ensuring that everyone involved in the arrangement is, as far as possible, safeguarded.

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Helping children make a positive contribution

Young people are consulted on a daily basis and are empowered, as far as it is possible, to consider their circumstances, behaviours, relationships and interactions and how this affects their choices and decisions. Opportunities are provided both formally and informally for young people to discuss any views they may have about their care and the running of the home.

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Helping children make a positive contribution

Staff strive to create an inclusive, reflective and participatory environment that encourages consultation and discussion. For example, young people have an opportunity to participate in the process of selection of new staff. This good practice is not always evident in young people's case notes and other documentation however, which do not always reflect the 'voice' of the child.

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Helping children make a positive contribution

Admissions to the home are handled well. There is rigorous assessment to ensure that young people will benefit from being placed at the home, and that the placement will be a good 'match' with young people already resident at the home. Young people are given support, time and space to prepare for moving into this therapeutic environment and a gradual introduction is effected. When young people leave the home the occasion is marked and an 'end of placement' report is provided for those moving on to other establishments.

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Achieving economic wellbeing

The provision is good. Young people do not have formal pathway plans, but despite this there is good support in preparing for adulthood and leaving care. Careful consideration is given to young people's emotional and psychological status and any planning and intervention in developing skills in independence takes this into account.

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Achieving economic wellbeing

Young people live in a comfortable home, which is furnished to a high standard and creates a pleasant, relaxed environment. It provides ample space for the number, age and gender of the young people living there and the design, layout and use of the accommodation allows young people to receive individual care in privacy if necessary.

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Achieving economic wellbeing

All young people have their own bedrooms where they keep their personal belongings. Both the interior and exterior of the home are maintained in a good state of structural and decorative repair. The home is clean and any damage is quickly responded to. The garden and extensive grounds are also kept tidy and free from hazards.

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Organisation

The organisation is satisfactory. The home's statement of purpose is regularly reviewed to ensure it accurately reflects what the service provides. The children's guide helps young people to understand what services they can expect from the home and how they will be cared for. 7 of 9 Inspection Report: SC020151 Management of the home is generally effective. This contributes to the very positive impact on the outcomes for young people. Staff clearly understand the objectives of the service and what is to be achieved with each young person. Staffing arrangements are organised to support the effective management of the home and to meet the needs of young people. This is a well-established, competent staff group whose stability and longevity helps young people to experience positive attachments and a sense of safety and belonging.

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Organisation

Young people are cared for by staff assessed to be competent in discharging their duties. Staff receive regular supervision and appraisal. Staff training is well developed and provides various opportunities in which staff can enhance their knowledge and skills. Several staff are educated to degree-level, and the home meets the ratio of staff achieving the appropriate national vocational qualification.

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Organisation

The promotion of equality and diversity is good. Young people receive a service designed to meet their individual personal needs. Staff ensure they have sufficient knowledge and understanding to ensure that young people's diverse needs are consistently met. The staff team are balanced in terms of gender, age and experience. Young people mix with the local community which ensures contact with other individuals from diverse backgrounds.

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Organisation

Regular independent monitoring of the home provides a statutory check on the home's functioning. This identifies any shortfalls in practice or procedure and the impact on the care and welfare of the young people. Monthly regulation 33 visits are undertaken and reports sent promptly to Ofsted as required. Feedback received from the regulation 33 visitor has for example highlighted the need for communication to improve between management and staff.

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Organisation

Mechanisms to improve the quality of care provided for young people is insufficiently robust, however. Although regulation 34 checks are undertaken by the manager, this process is not in compliance with these regulations and no report is provided on these matters.

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Organisation

For example, records are not signed off by the manager and it is not evident that documentation, such as medication or menus, are being checked. A more rigorous management oversight would have identified the shortfalls highlighted in this inspection and would ensure that young people continue to benefit from appropriate care and high standards being maintained.

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Organisation

Administration within the home is excellent. Young people's records are in good order, methodically and systematically arranged and containing all essential information required by these regulations. Staff record detailed information about each young person's health, needs and wants. This facilitates good communication with other professionals, as well as ensuring that the young person have a secure, accurate record of their progress and development.

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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

8 of 9 Inspection Report: SC020151 6 November 2009 ensure accurate records are kept for the administration of any medicine to any child (Regulation 21 (2)(c) 6 November 2009 provide a written record, made in a volume kept for that purpose, the details of any physical restraint including points (a) to (g) of this regulation (Regulation 17)(4) 6 November 2009 establish and maintain a system for (a) monitoring the matters set out in Schedule 6 at appropriate intervals and (b) improving the quality of care provided in the children's home (Regulation 34 (1)

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Recommendations

There are no recommendations. 9 of 9 Inspection Report: SC020151

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