Children's Home run by Action for Children in Northumberland

SC000673 Unique reference number 19 July 2009 Inspection date Dennis Bradley 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 9 Inspection Report: SC000673

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Brief description of the service

The home, in partnership with the local authority and health trust, provides short-term residential care for children and young people, aged from six years old up to 17 years old, who have moderate to severe learning disabilities. The premises are purpose built and consist of two linked units.

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Brief description of the service

One unit has six places, including an emergency bed and normally accommodates children aged from six years old up to 13 years old. The other unit has four places and normally accommodates young people aged from 11 years old up to 17 years old. There is a range of aids and adaptations within the home. The premises includes a garden and enclosed play area. The home has the use of two adapted mini-buses.

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Brief description of the service

The home is within walking distance of the centre of a market town and is close to a variety of community resources, that includes a leisure centre, swimming pool, theatre and library.

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Summary

At this full inspection, all the key standards were inspected. The inspection also looked at the progress the service has made with the recommendations made at the last inspection. These related to staff training and recording measures of control and discipline. The inspection was unannounced.

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Summary

There was evidence of very positive relationships between the staff and the young people who use the service. There are good arrangements for protecting and promoting the health of the young people. Staff try to make sure the home provides a secure, safe setting for the young people. However, young people and their parents and carers do not receive all the appropriate information about how to complain and the action taken to identify and reduce potential risks is not fully satisfactory. Staff are very good at consulting the young people and involving them in decisions about their stay at the home. The home is good at supporting the education and achievement of the young people. The opportunities for staff to take part in training leading to a relevant qualification are satisfactory. Staffing levels provide opportunities for staff to carry out one to one work with the young people to help meet their assessed needs. The

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Summary

individual needs of young people are recognised and there are plans in place to address them. The promotion of equality and diversity is good throughout the standards inspected. The arrangements for providing some staff with appropriate support and supervision and for monitoring the service and the care and welfare of the young people, are not fully satisfactory. 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

The Registered Person was asked to ensure that staff receive ongoing training in safeguarding children; when sanctions or restraint are used, young people are encouraged to write or have their views recorded in the records kept by the home. The Registered Person has taken appropriate action to comply with both of these recommendations. 4 of 9 Inspection Report: SC000673

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Helping children to be healthy

The provision is good. The young people benefit from being cared for by staff who actively promote their health and well-being. Staff encourage the young people to eat healthy meals and they are given choices regarding the food they eat. A young person said staff ‘…cook healthy food and soup’. Staff are very aware of the different dietary needs of the young people. Older children can help with planning and preparing meals. Staff are good at monitoring the health of the young people and they take appropriate action where necessary. The young people’s care plans set out how their health will be promoted. Staff have a good understanding of a range of health care needs and many have received more specialised training in meeting the specific health care and dietary needs of some young people.

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Helping children to be healthy

There are good arrangements for storing, administering and monitoring the young people’s medication. These help protect their health and meet their health care needs. There are suitable records and procedures covering the administration of medicines for this purpose. Most staff have had relevant training. Staffing arrangements ensure appropriate support is available for the young people at all times. For example, there is always a member of staff on duty who is trained in first aid. However, appropriate consent for staff to administer first aid has not been obtained for all of the young people.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Young people’s privacy and dignity is promoted. This is evident when staff support and assist young people with their personal care. Staff also respect young people’s preferences regarding their personal care. They make sure information about young people is handled confidentially and stored securely. There are detailed policies and procedures in place to help ensure this happens.

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Protecting children from harm or neglect and helping them stay safe

There are clear procedures for managing complaints appropriately and ensuring young people and their families are listened to. Information about how to complain is available in different formats to meet the communication needs of some of the young people. Staff treat any complaints or concerns seriously and deal with them promptly and appropriately. However, the information for young people and their parents or carers, about how to complain does not include all the recommended information, such as how they can secure access to an advocate. Most of the staff have not had any training in the home's complaints and representations procedures.

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Protecting children from harm or neglect and helping them stay safe

The home has robust procedures for safeguarding young people from abuse. There are suitable arrangements for making sure that staff receive child protection training. This helps staff protect young people from abuse and ensure they respond appropriately to any allegation or suspicion of abuse. There are no current safeguarding issues but records show that staff take appropriate action where there are any such concerns.

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Protecting children from harm or neglect and helping them stay safe

The young people benefit from being looked after by a team of staff who create an atmosphere where bullying is known to be unacceptable. The home has a clear anti-bullying policy but the general bullying risk assessment is not fully satisfactory. It does not clearly identify the action to be taken to reduce the risk of bullying when only two staff are on duty and both are involved in administering medication to young people. Staffing levels and the vigilance of staff helps 5 of 9 Inspection Report: SC000673 to make sure that any bullying behaviour would be dealt with promptly. Staff try to help the young people to develop an understanding of each others diverse needs and the importance of tolerance.

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Protecting children from harm or neglect and helping them stay safe

There have been no incidents involving young people going missing. This is due to the level of supervision staff provide as well as young people being unable to leave the premises without permission.

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Protecting children from harm or neglect and helping them stay safe

Staff are good at encouraging and supporting the young people to develop and maintain socially acceptable behaviour. They give very positive messages to young people to reinforce acceptable behaviour. Staff rarely use sanctions and when they do these are relevant and reasonable. There are clear procedures and guidance for staff regarding how they should manage the behaviour of young people. Some young people have individual behaviour management plans and staff agree these plans with the young people’s families and relevant professionals. All but two of the permanent staff have had recent training in positive behaviour management.

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Protecting children from harm or neglect and helping them stay safe

The systems in place to keep the young people and adults safe from the risk of fire and other potential hazards are not fully satisfactory. Staff take part in regular fire training and fire drills. There are good arrangements for carrying out regular checks of equipment, such as fire alarms and electrical appliances. Staff carry out a range of risk assessments, including specific individual risk assessments for each young person. However, an appropriate risk assessment has not been completed in relation to hazards identified by some staff when using a hoist in one of the units and no action has been taken to reduce or avoid the risks identified.

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Protecting children from harm or neglect and helping them stay safe

The Registered Manager takes appropriate action to help make sure the home only employs suitable people. The provider carries out a range of checks on new staff before they start working at the home. This includes a Criminal Records Bureau disclosure check. Staff also carry out appropriate checks on any agency staff who commence working at the home. There are suitable arrangements for monitoring and managing visitors to the home. These help to ensure they do not have inappropriate access to young people.

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Helping children achieve well and enjoy what they do

The provision is good. Young people benefit from having care plans and risk assessments that are based on their individually assessed needs. For example, these plans identify any cultural or religious needs a young person may have. Staffing levels provide opportunities for staff to give the young people support and assistance to meet their individual needs and wishes. Staff are knowledgeable about the individual needs of the young people and the implications this has for their care. There was evidence of very positive interactions between staff and the young people.

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Helping children achieve well and enjoy what they do

The home values educational achievement. It provides transport to enable the young people to attend school. Staff have appropriate links with the schools and attend relevant meetings.

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Helping children make a positive contribution

The provision is good. The young people benefit from having placement plans that set out how the home will meet their assessed needs. However, they vary in quality, for example, in how goal plans are devised and evaluated. Some staff have had training in using communication systems to support young 6 of 9 Inspection Report: SC000673 people to communicate their needs and wishes more effectively and to be more active in making decisions. However, this training has not been kept up to date and many of the staff have not received any training in using communication systems.

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Helping children make a positive contribution

There are good arrangements for reviewing the care and progress made by the young people. These include holding regular statutory reviews. Staff support the young people to contribute to their reviews. Staff also have regular contact with the young people’s parents or carers.

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Helping children make a positive contribution

Staff ensure young people are able to commence using the service in a planned and sensitive manner. This includes carrying out a comprehensive assessment of each young person’s individual needs to make sure the home can meet them. Staff take account of the individual needs and wishes of each young person when arranging introductions to the home.

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Helping children make a positive contribution

Staff are good at involving the young people in making appropriate decisions about their stay at the home. For example, what outings or activities they would like to take part in and their preferences regarding how staff provide personal care. Staff take the views and opinions of the young people seriously and where possible and appropriate act upon them. There are also good arrangements for consulting parents and carers about the care of their children while they are staying at the home.

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Achieving economic wellbeing

The provision is satisfactory. Staff help prepare and support the young people to make the transition to adulthood. For example, older children have care plan goals that include developing practical, daily life skills. Staff also work with the young people and their families to prepare them for moving on from the service. This includes the preparation of ‘memory books’ about the times they have been to the service, which they take with them when they leave.

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Achieving economic wellbeing

The young people benefit from accommodation that is homely, decorated and maintained to a satisfactory standard and has been equipped to meet their individual needs. For example, there is a sensory room and the bathrooms are designed and equipped to take account of young people’s need for safety and accessibility. The home’s kitchens have recently been refurbished and decorated and there are plans for redecorating the rest of the home.

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Organisation

The organisation is satisfactory. The home has a statement of purpose that provides clear information about how it operates. There is also a young people’s guide that provides a useful introduction to the home. Both refer to the home’s commitment to promoting equality and diversity. The home operates in line with its statement of purpose.

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Organisation

There are satisfactory arrangements in place for making sure full and part-time staff receive appropriate support and supervision in safeguarding and promoting young people’s welfare. However, the arrangements in place for relief staff and agency staff are not satisfactory. This is because they do not receive one to one supervision from a senior member of staff after each eight shifts they have worked in the home. Full and part time staff also receive an annual appraisal. 7 of 9 Inspection Report: SC000673 There are satisfactory arrangements for providing staff with training in caring for children and young people. Over 80% of the care staff, excluding relief staff, have a suitable qualification confirming they have the competencies needed to care for young people. Some of those who do not are either undertaking, or due to commence suitable training. Apart from core training, such as moving and handling staff can also access some short courses that cover the specific

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Organisation

needs of some of the young people. Staff receive training in equality and diversity as part of their induction training. However, most staff have not had any training covering complaints and representations and many of the staff have had no training in communicating with children with disabilities. There are good arrangements for providing full and part time staff with induction training and this is clearly recorded. However, staff do not keep an appropriate record to evidence the induction provided to agency staff.

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Organisation

Staffing levels are satisfactory and enable staff to spend time meeting the individual needs of the young people. Whenever it is possible there is a mix of male and female staff on duty. The home employs a pool of relief staff who provide cover at the home. This reduces the number of agency staff used by the home which helps maintain continuity of staffing. This helps to reduce potential disruption to the young people. However, because of staff vacancies and staff absences, the home is currently using more agency staff than usual.

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Organisation

The promotion of equality and diversity is good. The young people receive an individual service designed to meet their personal needs and preferences. Staff have a good knowledge of the young people and try to make sure their needs are being met at all times. There is a commitment to improving equality and diversity in practice.

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Organisation

The arrangements for the internal and external monitoring of the home and the care and welfare of the young people are not fully satisfactory. A person carries out monthly unannounced monitoring visits and completes detailed reports that may identify actions that are required to improve the service. The Registered Manager also monitors the home’s records each month to identify any issues that they may need to address and they complete a report of the outcome of these checks. However, the Registered Manager does not monitor or report on all the required matters. For example, they do not regularly monitor the records of money and other and valuables young people give to staff for safekeeping and these records are not satisfactory.

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Organisation

Young people’s case files are properly kept and records of their needs, development and progress reflect each young person’s individuality.

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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 September 2009 ensure that all staff employed at the home receive appropriate supervision and appraisal (Regulation 27) 8 of 9 Inspection Report: SC000673 11 August 2009 ensure that all staff receive appropriate training, specifically training in complaints and representations procedures and communicating with children with disabilities (Regulation 27) 25 August 2009 establish and maintain a system for monitoring all the matters set out in Schedule 6 at appropriate intervals. (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): • obtain prior written permission from a person with parental responsibility for each child for the administration of first aid (NMS 13.4) • ensure that the information provided to children, and where appropriate their families, significant others and independent visitors includes the information specified in NMS 16 (NMS 16) • ensure risk assessments carried out in relation to the home’s premises and the potential for bullying within the home are comprehensive and include the action to be taken to reduce or avoid the risks identified (NMS 26) • ensure that agency staff receive one to one supervision no less frequently than after each eight shifts worked at the home (NMS 28.2) • maintain a record of the induction training provided to agency staff (NMS 31) 9 of 9 Inspection Report: SC000673

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