Lincolnshire Secure Unit

SC042921 Unique reference number 10 November 2009 Inspection date Malcolm Stannard / Linda Christie Inspector Key Type of 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 11 Inspection Report: SC042921

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Brief description of the service

This is a secure unit managed by a local authority children's services. It is located on the outskirts of a small town. The secure unit is registered as a children's home, but is also approved by the Secretary of State to provide secure accommodation for up to nine children and young people, aged between 13 and 17 years.

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Brief description of the service

At the time of inspection there were nine young people placed in the home.

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Brief description of the service

The home is presently undergoing a major rebuild. Department of Children Schools and Families funding has enabled the gym and school facilities to be upgraded. Further building work is ongoing to upgrade doors and windows, outside play and vocational areas, office accommodation and young peoples bedrooms.

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Summary

This was an announced inspection to evaluate the quality of care and security at the unit. The key standards in the Every Child Matters outcome groups were inspected along with progress against the recommendations from the last inspection which took place in July 2009. The formal education provided on site was not inspected during this visit.

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Summary

Strengths of the provision at the unit are the professional relationships staff have with young people which encourage positive behaviour, the robust child protection procedures in place and good planning to support young people in their transition back into the community. Areas for development include the role of key workers and the further use of data to inform practice at the unit.

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Summary

Young people are assisted to develop in all areas by the positive support available at the unit and are kept safe by good organisational practices. 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

There were two recommendations made at the last inspection of the unit. Management at the unit was asked to review the recording of restraints, incidents and sanctions to ensure clarity of information. Whilst new record books had been in place at the last inspection, they were being piloted to ensure all required information was able to be captured. The final versions of the books are now in place and enable all information to be entered in the relevant record and be readily available to staff and managers.

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Improvements since the last inspection

The taps in the bathroom available for young people's use had been identified as a potential ligature point and a recommendation was made that they be replaced. As part of the ongoing building improvement work at the unit, this bathroom is no longer accessible to young people. It will remain inaccessible until the work, which includes a total refit of the bathroom, is completed in this area. This recommendation is, therefore, removed.

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Helping children to be healthy

The provision is good. 4 of 11 Inspection Report: SC042921 Young people are provided with healthy and nutritious meals. There are menus available which have been drawn up with assistance from nutrition experts. Young people are able to contribute to the make up of the menu and can make known their views on the meals provided via a weekly consultation form. All comments made by the young people are shared with the kitchen staff. Any dietary requirements made known are able to be met and are noted in young people's records.

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Helping children to be healthy

A health plan is available for each young person which contains clear information and targets for each area of physical and emotional health. Where necessary, young people are supported by external health professionals for support and advice. A nurse from a local practice visits the unit and young people are able to see her in private to discuss any health issues; out of hours medical support is also available. There is good children and adolescent mental health service input, with a full-time mental health nurse in place who is supported by a psychiatrist. Support is also available in relation to substance misuse; an external worker undertakes group and individual sessions with young people. There are good working partnerships in place with outside agencies which ensure young people are able to access individual help.

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Helping children to be healthy

Policies and procedures relating to medication administration and handling are in place to guide staff members in their work to ensure young people receive the correct medication. Training is undertaken in first aid and medication awareness by all staff. The dispensing of medication is carried out according to the unit's procedures by two staff members and a robust auditing system is in operation. Storage of medication is secure. Appropriate written consents from the young people's local authority or parent for the administration of prescribed and non-prescribed medication, first aid and emergency medical treatment are held. Whilst a senior member of staff has now been given the responsibility of overseeing the medication systems in the unit, some tasks, such as repeat prescription ordering, are not undertaken by them. This could present the opportunity for a disjointed approach to replenishing the stock. Young people's welfare is

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Helping children to be healthy

protected by the unit's practice and procedures in relation to medication administering.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. The privacy and dignity of young people at the unit are respected. All confidential information is stored securely and staff members receive guidance relating to whom and for what reason any information may be shared. A complaints system is in operation which allows young people to make any concerns known. This can be accessed without the need to approach staff members. Issues may be raised which do not constitute a complaint can also be brought to the attention of senior staff at the unit by a separate system.

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Protecting children from harm or neglect and helping them stay safe

An independent advocate visits the unit on a regular basis and young people are able to have unrestricted access to her. Information about the advocate and the complaint system is available to young people in an information booklet and they can be confident that any issue raised will be responded to by staff.

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Protecting children from harm or neglect and helping them stay safe

There is a robust child protection system in place at the unit. Relevant policies and procedures are in place and there are excellent working arrangements with the Local Safeguarding Children Board. The unit's senior staff are able to access advice and guidance from the board and joint agency meetings take place quarterly. Staff are given comprehensive training in order to deal with an event or disclosure, allowing young people to be supported and appropriate procedures to be followed. Robust procedures are in place which enable the early identification of young 5 of 11 Inspection Report: SC042921 people who may be at risk of self harm. The systems in place ensure that the welfare of young people can be promoted.

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Protecting children from harm or neglect and helping them stay safe

The unit has a zero tolerance approach to bullying and there is a range of individual programmes and group workshops in place to address the issue. Records are held of any instance of bullying occurring and include details of any individual programme in place to manage it. Young people are encouraged to discuss the subject during their own meetings and support is given to resolve any issues which may have arisen.

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Protecting children from harm or neglect and helping them stay safe

Procedures are in place which guide staff to undertake the correct responses to young people who may be missing. Notifications are made to the appropriate authorities following any incident in accordance with Regulation 30.

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Protecting children from harm or neglect and helping them stay safe

Appropriate records are held of any restraints, sanctions or single separations which may occur. There is low use of formal sanctions, with staff members preferring to use positive reinforcement of behaviour initially. Staff members use some excellent examples of professional relationships with young people to encourage positive behaviour. The recording of sanctions and restraints has improved with the introduction of specific record books. This has enabled the pertinent information on each occurrence to be clearly identifiable and available. More detailed information regarding the antecedents and outcome of each event is now recorded on an incident form. Staff members receive training in the use of physical restraint techniques and behaviour management diffusion techniques. An incentive scheme is in place which acknowledges positive behaviour. Young people are able to access additional rewards, including the additional use of

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Protecting children from harm or neglect and helping them stay safe

electrical equipment and specific activities or interests.

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Protecting children from harm or neglect and helping them stay safe

There are good security, and health and safety procedures in place to ensure young people are protected from harm, including the completion of regular building risk assessments. Fire procedures are well established, including evacuation drills which are carried out each month and during periods when the night team are in charge of the building. All tests of the fire alarm system and drills are recorded. Staff receive training in the fire procedures as part of their induction and there is ongoing training as appropriate.

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Protecting children from harm or neglect and helping them stay safe

The building is well maintained, regular checks are made and services undertaken of electrical wiring, emergency lights, fire extinguishers and of gas installations. Young people are well protected by such thorough procedures.

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Protecting children from harm or neglect and helping them stay safe

The recruitment and selection of people working at the unit are robust to make sure young people are protected. All staff working at the unit have had an appropriate Criminal Records Bureau check. In addition, the vetting and supervision of visitors to the unit is thorough.

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Helping children achieve well and enjoy what they do

The provision is good. There are good working relationships in place between the care and education teams. Good lines of communication exist which means that joint enrichment activities can successfully promote learning for young people. Care staff support young people to achieve their best in education and encourage the completion of homework and the preparation of equipment required for school. 6 of 11 Inspection Report: SC042921 A comprehensive programme of activities is available during the week, with evenings split into sessions where group and one to one sessions can be carried out followed by a physical and entertainment based activity. On a weekend, there is a strong emphasis on youth club style activities, with young people preparing their own snacks to be eaten whilst undertaking different sports and games in the evening. Good use of external providers is made, with theatre groups, sports coaches and motivational groups all carrying out sessions. Clubs, such as nail art and

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Helping children achieve well and enjoy what they do

horticulture, are also provided, and young people are able to undertake sports leaders award qualifications. A system which allows all young people to partake in activities and rewards positive behaviour on a daily basis has being introduced. There are some opportunities to undertake vocational work, including a lawnmower renovation scheme, which encourages joint working with peers. A skills audit of staff interests and abilities is available and staff are motivated to encourage participation by young people.

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Helping children achieve well and enjoy what they do

Good resources are available for young people to engage in active pursuits and include a new sports hall and recently completed outdoor play area. Craft materials and electronic games machines are also provided where appropriate. Young people are supported to engage in activities and follow any particular interests they may have.

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Helping children make a positive contribution

The provision is good. Good procedures are in place ensuring thorough assessments are carried out to identify the needs and challenges presented by young people at the time of admission and routinely throughout their stay. Effective systems ensure that relevant information about young people is obtained at the point of admission and used to make a full assessment of their needs. Other professionals play an important role in the detailed assessment, including mental health and drug and alcohol practitioners. The multi-disciplinary approach in this respect is excellent.

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Helping children make a positive contribution

Young people receive good direction and support from staff during their admission and period of induction, as do their parents. Initial assessments also include agreements for contact with families and visits are arranged as quickly as possible. Young people’s individual and diverse needs are identified, including any religious preferences and their parents play an active role in such planning.

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Helping children make a positive contribution

Care and sentence planning is well managed. Each young person has a clear plan outlining the targets for specific intervention work, which is delivered either through one to one sessions or group work. Young people have allocated key workers who are involved in addressing the individualised targets using a range of packages, many of which are accredited and result in young people receiving AQA awards for completing the sessions.

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Helping children make a positive contribution

All interventions related to the specific targets are well monitored and amended to ensure young people’s planned objectives are achieved. They are discussed with the young person by their key workers and case managers to ensure they understand and agree with them. Any future targets are agreed in placement review meetings. Staff involved in one to one or group sessions with young people submit a written evaluation of the session, but young people are not invited to make a written comment.

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Helping children make a positive contribution

Case reviews take place in keeping with expected national standards. There is a clear focus on reviewing agreed actions and targets and there is evidence that the young people’s views are taken into account. Parents are considered an important stakeholder in the decision-making 7 of 11 Inspection Report: SC042921 and reviewing process. Although case review meetings are well organised and chaired by case managers, key workers do not routinely attend the meetings. They usually submit a report, but the level of involvement they have with the young people in relation to addressing identified targets is not sufficiently well reflected in review meetings.

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Helping children make a positive contribution

Young people’s achievements are recognised and affirmed by a staff team who understand the importance of building self confidence and self esteem. Young people enjoy sound relationships with staff based on honesty and mutual respect. Staff have equally positive relationships with external professionals, placing agencies and parents. All parties external to the secure unit spoken with during the inspection were glowing in their praise of the care and service provided to young people. This included young people’s families. They all reported being kept well informed of progress or issues specific to the young people and routinely received weekly and monthly reports.

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Helping children make a positive contribution

Consultation with young people is good. They are consulted about matters related to the day to day routines of the unit. Records show young people are listened to and action is taken to implement their suggestions, where feasible.

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Achieving economic wellbeing

The provision is good. There is good planning for young people to ensure they are appropriately prepared and supported to enable a successful transition back into the community. Staff are also aware of the importance of assisting young people to develop self reliance skills in preparation for adulthood.

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Achieving economic wellbeing

Assessment planning identifies the aspects of life skills that young people require support to develop. An excellent independence cooking programme is in place which is tailored to individual needs and includes cultural considerations. Young people are very positive about the opportunities to plan, budget and prepare meals, which they believe will be useful in the future. There is a range of other packages available for young people when preparing for adulthood, including opening bank accounts, preparing for college courses and planning for future accommodation.

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Achieving economic wellbeing

When needed, managers will take action to ensure the needs of individual young people are met by external agencies. For example, staff consistently and effectively remind children’s services authorities and youth offending teams of their responsibilities to the young people placed in the unit. Children’s advocacy agencies are also actively involved in advocating for individual young people with their placing agencies when it is clear that pathway planning is inadequate.

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Achieving economic wellbeing

Young people are able to make choices about the purchasing of clothing, toiletries and other items and are supported by their key workers if they are unable to leave the secure setting.

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Achieving economic wellbeing

There has been a major redevelopment of the building taking place for several months and this is still ongoing. The unit has a new education facility, gym, large external play area, revamped admission suite, replacement windows and doors, new conference room, new laundry and extended administration facilities. During the current phase of redevelopment there will be four additional bedrooms for young people, another lounge, a room for private counselling and 8 of 11 Inspection Report: SC042921 a fitness suite. It is anticipated that the telephone system will be enhanced and a vocational workshop will be built within the secure perimeter.

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Achieving economic wellbeing

Managers and staff have done an excellent job in managing the potential risk from having major building development work ongoing for several months. Good risk assessed procedures are in place to ensure the work of the contactors does not impinge upon the young people’s living space and to maintain a homely environment for them as far as possible.

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Achieving economic wellbeing

The new additions to the building are already beginning to have a positive impact on the quality of life for young people.

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Organisation

The organisation is good. There is a comprehensive statement of purpose available that effectively describes the aims and objectives of the unit. This is a well written document and includes all the details as required, including those regarding managers and staff.

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Organisation

Good comprehensive information, which is written in a user friendly format, is given to parents explaining what they and their child can expect from the unit.

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Organisation

As part of their thorough induction into the unit, young people are provided with an information booklet which provides a range of information. A DVD is also available for young people explaining the services they can expect and expectations of them. The information is not yet available in different languages for those young people for whom English is not their first language. Arrangements are made for translators to attend reviews and assist with communication for young people or their parents, as necessary. Although the DVD is a positive resource, young people who might have a learning disability do not have access to written information that can easily be understood by them, for example with the use of widget symbols.

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Organisation

The unit is effectively managed by an experienced and committed management team. Staff are well supported in their work with young people. All staff are clear about the expectations of them and the majority fully endorse the aims and objectives of the unit.

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Organisation

Lines of accountability are good and have recently been further strengthened by a review of the role of the shift managers. There are appropriate expectations about formal supervision and staff are supported by their line managers and by the policies and systems that are regularly reviewed. All staff have recently been subject to an annual appraisal of their performance and have clear objectives for their development.

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Organisation

The importance of staff development is understood and efforts are made to provide staff with opportunities to obtain qualifications. Over 81% have the National Vocational Qualification at level 3 in child care. Staff training and development planning are well managed by the training officer. The induction of new staff and the support for them are good. However, the priorities regarding core training for new staff prior to working with the young people are unclear.

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Organisation

There is a good balance of age and gender mix within the staff team, but not of cultural and ethnic backgrounds. Managers attempt as part of recruitment campaigns to recruit staff from diverse backgrounds, but this is difficult given the demographic of the population in the local community and the region. 9 of 11 Inspection Report: SC042921 Young people benefit from a settled group of staff, which facilitates consistency of relationships and quality of care. There are sufficient staff to meet the needs of young people and often the number of staff on duty exceeds the agreed safe minimum level. Young people benefit by having regular opportunities for one to one time with their key workers.

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Organisation

There is an effective system in place to ensure the external monitoring of the unit. Regulation 33 visits are conducted regularly and generally to a very high standard. There are also regular visits from a local elected member, who is very supportive of the work of the secure unit.

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Organisation

All young people’s records are held securely. There are individual records held for all young people which reflect their development and the direct work interventions carried out with them. They contain all the information required by regulation and action is taken to challenge placing agencies who do not provide appropriate information. Although hard copy files continue to be maintained, all records are also held on an electronic case management system, as required by the Youth Justice Board. As records are regularly monitored by case managers and the deputy manager, and any discrepancies raised with relevant staff.

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Organisation

There are good systems in place to ensure quality of practice across all aspects of the work of the unit, including recording and reporting. A number of systems collate performance management information. There is for example a range of information about incidents, enrichment activities and interventions with young people that the unit are required to provide to the Youth Justice Board. There is also some workforce data that have informed action taken by managers, for example the focus on sickness absence. However, the processes whereby performance management information is collated, analysed and used to inform practice and development are underdeveloped.

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Organisation

The promotion of equality and diversity is good. Care is taken to assess individual needs and ensure young people have access to services they require. For example, one young person for whom English was not his first language, was receiving support from a local organisation who assisted with literacy and comprehension whilst in education. The individuality of young people is well respected and supported and all young people are encouraged to celebrate their cultural and religious beliefs. Young people are encouraged to consider other groups within society who are disadvantaged and they are actively involved in raising funds for charities.

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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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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • review the system in place for repeat ordering of medication in relation to one contact point being available for health professionals (NMS 13) 10 of 11 Inspection Report: SC042921 • ensure young people have an opportunity to evaluate the one to one and group work sessions they participate in to address their specific care and sentence plan targets (NMS 2) • review the role of key workers in case management delivery, including their attendance at case review meetings (NMS 2 & 3) • review the performance management systems to ensure service development is informed by systematic analysis of information. (NMS 33) 11 of 11 Inspection Report: SC042921

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