Children's Home run by North Lakes Children’s Service Limited in Cumberland

SC398253 Unique reference number 10 May 2010 Inspection date Anne Bannister Inspector Key Type of Inspection

p.1

18 November 2009 Date of last inspection .

p.1

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.

p.2

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

p.2

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.

p.3

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: SC398253

p.3

Brief description of the service

This five bedded children's home is one of two run by the company. The home is in a small village with education being provided in a purpose-built school on the company's other site. It is a detached house with its own grounds. All young people have single en-suite bedrooms. The quality of the accommodation provided is of a high standard. Young people enjoy homely accommodation which is well furnished and decorated. The home has access to a range of local facilities in a nearby city and villages. It is registered for five males, aged from 14 years old up to 17 years old with emotional and behavioural problems. Two young people were living at the home at the time of the inspection. Young people and staff were actively involved in this process.

p.4

Summary

This judgement is reached following an unannounced full key inspection of the home over two days. Compliance with the regulations and the key national minimum standards was assessed in all the outcome areas.

p.4

Summary

Young people confirm they enjoy sound relationships with the staff; they like the food and activities provided; they like their own bedrooms and they can personalise them. There are also good opportunities to positively contribute to their daily lives and futures. They are making good progress in achieving their potential. All young people confirm that they feel safe within the home and bullying is not an issue.

p.4

Summary

The staff team demonstrates good practices in their working relationships with young people. However, the way that records are maintained fails to evidence all the work that is being undertaken. Placement plans in particular do not reflect the way staff are supporting young people. This weakness impacts on most of the outcome judgements. The monitoring systems in place need further development as they are not sufficiently robust. Three actions and ten recommendations have been made as a result of this visit. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection.

p.4

Improvements since the last inspection

Four actions and seven recommendations were made following the home's first inspection in November 2009. Two of the actions related to health and safety issues. The risks relating to the bedroom door closing mechanism has been addressed. In addition, valves have been fitted to regulate the water temperatures in young people's bedrooms. Young people now sign the complaints record to indicate that they are happy about the way issues they have raised have been resolved. The final action related to frequency of staff supervision. The majority of staff now receive supervision within the required timescales. Additional staff have completed supervision training. In future this will ensure that the Registered Manager is able to delegate some of these tasks.

p.4

Improvements since the last inspection

Of the seven recommendations three have been addressed. Comprehensive transition plans are now in place to support young people moving into the home. Incidents of bullying occurring during the school day are now dealt with by teaching staff. Documentation maintained on 4 of 11 Inspection Report: SC398253 physical interventions ensures that both staff and young people are encouraged to reflect on any incident which occurs.

p.4

Improvements since the last inspection

Four outstanding recommendations link to the need to develop young people's placement plans further. This particularly relates to the need to reflect how the care staff team act as 'good parents' in supporting young people's education. Placement plans also need to fully reflect the high quality of care that is provided to address young people's individual identified needs. The organisation has yet to provide staff with training in the promotion of equality and diversity.

p.5

Helping children to be healthy

The provision is satisfactory. The health and well-being of young people is well monitored. Discussion with staff and young people indicates that menus offer young people access to a balanced, healthy diet. All young people spoken to confirm they are involved in planning the menu. However, the manner in which some menus are recorded does not always reflect how healthy eating is being promoted. Some of the recordings fail to detail that fresh vegetables or salads are routinely presented to young people. All care staff, except one recently appointed staff member, have received certificated food hygiene training. This ensures they are aware of safe working practices and the procedures to follow when preparing food for young people. Mealtimes continue to be relaxed social occasions in which appropriate social skills are encouraged.

p.5

Helping children to be healthy

Young people have detailed health plans which are formally reviewed each month. Young people's records show that following any appointment, the nurse routinely updates care staff on the outcome. However, the monthly updated health plans fail to reflect on issues which may have arisen. Young people's health records indicate that specialist support and advice is sought to meet assessed needs. One health plan viewed did not include significant issues which were logged on a young person's individual risk assessment. This deficit had not been identified in the organisation's own quality monitoring systems.

p.5

Helping children to be healthy

The home operates procedures that comply with the administration and safekeeping of medicines. These are effectively monitored by the Registered Manager and by the school nurse. All staff have received formal training in the safe storage, disposal and administration of medication. This ensures they are aware of appropriate procedures to follow.

p.5

Protecting children from harm or neglect and helping them stay safe

The provision is good. Overall the arrangements in place to promote the welfare and safety of young people are good. The staff team are highly committed to ensuring that young people in their care are protected from harm. The young people's privacy is respected. This is clearly evident in how the daily routine is managed and how information is shared and recorded between staff.

p.5

Protecting children from harm or neglect and helping them stay safe

Reporting of safeguarding incidents complies with local safeguarding procedures and the Ofsted protocol for reporting significant incidents. Staff receive annual safeguarding training to ensure their practice continues to promote young people's safety. Arrangements for complaints, bullying and behaviour management are handled well. This ensures that young people feel listened to and protected. Bullying has not been an issue within the home. Young people's views are staff would address and deal with bullying, if this became an issue. 5 of 11 Inspection Report: SC398253 Staff take young people's concerns and complaints seriously. Young people spoken to know what to do if they are unhappy and how to make a formal complaint. There have been three complaints made by young people since the last inspection. They do not relate to the care provided in the home but to issues arising when they are attending education. The complaints

p.5

Protecting children from harm or neglect and helping them stay safe

procedure does not clearly advise staff of the records they are to maintain when a complaint is made about another service operated by the organisation.

p.6

Protecting children from harm or neglect and helping them stay safe

The home has written procedures identifying action to be taken when a young person goes absent without authority. This is not a current problem in the home. The procedures in place ensure that young people's welfare is promoted.

p.6

Protecting children from harm or neglect and helping them stay safe

Risk assessments are produced to highlight concerns and vulnerability. Detailed behaviour management plans are produced to support staff practice. Staff are competent in supporting the young people's needs. All staff are trained in methods and techniques of physical intervention. Staff endeavour only to use physical intervention in extreme circumstances. They prefer to use their skills in de-escalation to try to support young people experiencing difficulties. There has been only one incident were staff have needed to physically restrain a young person since the home was registered. Behaviour management plans and risk assessments are agreed as part of placement planning arrangements. Staff confirm that discussions take place, both in team meetings and at the end of each shift, to ensure they are responding consistently to young people's behaviours. However, there is little written evidence to confirm this. Staff

p.6

Protecting children from harm or neglect and helping them stay safe

practice observed aims to ensure the continued safety of both young people and the staff team working in the home.

p.6

Protecting children from harm or neglect and helping them stay safe

There are sufficient baths, showers and toilets, to fully meet the needs of the young people who may be accommodated at any one time. All young people benefit from having en-suite bathrooms. All hot water taps used by young people have temperature regulators fitted to them.

p.6

Protecting children from harm or neglect and helping them stay safe

Evidence and observation shows that the home has a responsible attitude towards health and safety matters. The home has risk assessments in place for all aspects of the safety of the premises and grounds. Appropriate risk assessments relating to young people's behaviours and planned activities are in place. These risk assessments are regularly reviewed and updated to ensure young people's continued safety.

p.6

Protecting children from harm or neglect and helping them stay safe

Actions relating to controlling water temperature and the closing mechanism on a fire door have been addressed. Fire risk assessments, fire alarm tests and fire safety equipment checks are up to date. The fire officer has given permission for some fire doors to be wedged open during the day. This is to ensure young people can be adequately supervised. However, the home's the fire risk assessment does not indicate the responsibility of shift leaders to remove any wedges in the event of the fire alarm sounding. All gas and electrical appliances receive an annual check. Overall the home's actions show that there is a commitment to ensuring young people live in a safe and secure environment.

p.6

Protecting children from harm or neglect and helping them stay safe

Visitors are welcomed to the home once they have satisfied staff of their identity, the purpose of their visit, and have signed the visitors book. In relation to all other aspects of their care the staff team takes all reasonable measures to ensure young people live in a safe environment. 6 of 11 Inspection Report: SC398253 Recruitment files examined indicate that the organisation operates appropriate recruitment procedures that meet the requirements. All required pre-employment checks are carried out and staff recruitment records are well maintained. Senior staff involved in recruiting have recently undertaken training in safe recruitment practice. This shows that all reasonable steps are taken to ensure that staff employed are suitable to work with young people.

p.6

Helping children achieve well and enjoy what they do

The provision is satisfactory. Observation of staff practice and written records clearly indicate that young people receive personalised support. Regular liaison with specialist agencies ensures that care staff are aware of any issues that might affect young people’s well-being. All staff spoken to are knowledgeable about young people's individual needs. Staff are constantly reviewing the manner in which they relate to young people. This ensures they are enabling young people to communicate their needs, wishes and concerns.

p.7

Helping children achieve well and enjoy what they do

Education plans are arranged to suit the young person’s individual needs and this was confirmed through documentation. Each young person's file contains a copy of their individual education plan. Care staff support young people's learning needs through close liaison with teaching staff. This ensures young people's individual educational needs are met. The way care staff achieve this is not well documented in the young people's placement plans. Young people's files do not contain copies of their personal education plans. Placement plans do not adequately reflect how care staff, acting as a 'good parent', support young people.

p.7

Helping children make a positive contribution

The provision is satisfactory. The care team is skilled at identifying and supporting young people's needs. However, some records fail to appropriately reflect how staff provide support to meet an individual's assessed needs. There are significant areas of documentation which fail to adequately evidence the good practice which care staff implement. The placement plans in place remain lengthy documents which are not evidencing the many ways in which the care staff team are addressing young people's assessed needs. Particular weaknesses have already been identified in relation to meeting heath care and educational needs. The lack of this information means both staff and young people are unclear about the targets they are working towards. It makes it difficult for staff to fully evaluate the progress young people are making.

p.7

Helping children make a positive contribution

Young people are assisted to maintain constructive contact with parents, family and other people significant in their lives. Contact arrangements are discussed at the time of the young people's admission and are recorded in their placement plan. Staff work closely with the young people's families and carers. Young people's views and those of their parents/carers and placing authorities are routinely sought and taken in to account. This practice ensures that young people's relationships with key people in their lives is maintained whilst they are living away from home.

p.7

Helping children make a positive contribution

One placing authority indicates that the staff team's commitment to a young person as, 'going above and beyond what would normally be expected of residential staff.' They also comment that staff show a 'dedication and commitment to young people in their care.' Staff support young people, and enable them to prepare for and express their opinions in statutory reviews. However, the minutes of statutory reviews are stored at the organisation's main site and are 7 of 11 Inspection Report: SC398253 not available on the young people's files. This means the inspector is unable to judge whether the home is pursuing actions arising from the statutory reviews. It also means staff are unable to ensure they are fulfilling responsibilities that the review has delegated to them.

p.7

Helping children make a positive contribution

There have been significant developments in the practice implemented when young people move into the home. Young people admitted to the home are well known to the organisation, previously have been cared for in one of their other registered homes. Comprehensive, detailed transition plans are put in place to support the young people during this period of change. The outcomes for young people, as a result of the detailed transition plans implemented, is good. The length of the period of transition is tailored to meet the young person's individual needs. Young people visit the home before admission. They meet with staff and young people resident and they are given relevant information on how the home operates. Young people already living in the home are informed and consulted about new admissions. The organisation takes into account any possible impact new admissions may have on those already resident. This

p.8

Helping children make a positive contribution

ensures that the needs of young people living in the home are compatible.

p.8

Helping children make a positive contribution

Staff encourage young people to be involved in all aspects of planning for their future. Young people confirm this. Weekly residents' meetings give young people opportunities to discuss issues relating to community living. Young people also benefit from fortnightly one-to-one sessions with their key workers. Staff are very approachable, young people can discuss issues at any time.

p.8

Achieving economic wellbeing

The provision is satisfactory. Staff are skilled at supporting young people to develop their social skills, self esteem and self confidence. Staff work towards preparing young people for independence. Care staff are keen to assist young people develop their skills to live independently. Programmes of independence are being formally developed and will link in with local authority pathway planning. In the meantime, young people are encouraged to assist with meal preparation, shopping and keeping their own rooms tidy. They are also encouraged to develop skills in budgeting.

p.8

Achieving economic wellbeing

The home is in a small village. It is a detached house with its own grounds. The home has access to a range of local facilities in a nearby city and villages. Young people have access to a games lounge, dining room, quiet lounge, kitchen as well as extensive gardens. The detached garage has recently been refurbished and now provides young people with space to enjoy pool and table tennis. The quality of the accommodation provided is of a high standard. Young people enjoy homely accommodation which is well furnished and decorated. There is ample space for young people to engage in leisure activities as well meet with visitors in private.

p.8

Organisation

The organisation is satisfactory. Overall arrangements for managing the home are satisfactory. Actions and recommendations arising in this report result in the overall judgement given. The home is adequately managed, providing a safe environment for the young people who live there. The Statement of Purpose is clear and sets out the care the home offers and they will provide this.

p.8

Organisation

The promotion of equality and diversity is satisfactory. The home assesses and determines the individual needs of young people in areas such as culture, religion, risk assessments and equality. 8 of 11 Inspection Report: SC398253 However, weaknesses in fully recording the work undertaken with young people to promote their individuality results in a satisfactory judgement. The organisation continues to develop the format of placement plans. However, young people's files do not evidence any significant improvements in placement planning since the November 2009 inspection. At this inspection placement planning was judged as satisfactory. Practice observed during the course of the two day inspection would indicate that the promotion of equality and diversity is good. Matters that promote fairness, such as access to the complaints system and reviewing of sanctions used with the young people are good. Staff have still not received training in the promotion of

p.8

Organisation

equality and diversity. This is an outstanding recommendation from the previous inspection.

p.9

Organisation

Although the majority of staff now receive formal supervision within the required timescales, this is not the case for newly appointed staff. On an informal basis new staff feel supported from the Registered Manager and the care team they work with. Additional staff are undertaking supervision training during the course of the inspection and it is envisaged that some supervision responsibilities will be re-allocated once this training is completed. The organisation has a performance appraisal scheme which is being implemented with the staff team. This will ensure all staff have personal development plans in place. These actions will ensure that young people are cared for by a staff team that are supported, both formally and in informally, in their roles to meet young people’s needs.

p.9

Organisation

Viewing of staff duty rota's, and observation of working practices, show the home is adequately staffed. The home employs waking night staff. One member of the care staff sleep-in each night to provide additional support, if young people require it. Staffing levels mean cover is available during periods of any staff sickness or holidays. Therefore, young people receive consistent care.

p.9

Organisation

Staff training programmes include a thorough induction programme. The staff team appear competent in their roles. Staff either hold, or are working towards the National Vocational Qualification at Level 3. There is a programme in place to achieve an 80% qualified staff team as per the standards. These actions show the home has systems in place for staff to obtain relevant training and qualifications.

p.9

Organisation

Monthly monitoring visits by the responsible individual and the Registered Manager are carried out and form part of the quality assurance system of the home. However, quality monitoring systems have failed to pick up issues raised in this report and therefore need to be developed further.

p.9

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.

p.9

Due date Action Standard

30 June 2010 promote and protect the health of children accommodated in the children's home. In particular this relates to the need to 9 of 11 Inspection Report: SC398253 ensure health plans reflect all information known about a children's medical history (Regulation 20(1)) 30 June 2010 take adequate precautions against the risk of fire. In particular this relates to ensuring that the fire risk assessment addresses staff responsibility in relation to the use of door wedges (Regulation 32(1)(a)) 30 June 2010 ensure that young people's files evidence that the home's placement plans are consistent with any plan prepared by the placing authority. In particular this relates to the need for copies of review minutes being available on individual files. (Regulation 12(4)(a))

p.9

Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure a written record is kept of all significant illnesses of, accidents by or injuries to children during their placement at the home. In particular this recommendation relates to the need to ensure that the monthly update of health plans reflects any issues which have arisen during the course of the previous month (NMS 12.3) • ensure that the record of menus (as served) demonstrates provision of a suitable and varied diet. This relates to the fact that staff do not always record salads, and vegetables served with meals (NMS 10) • review the record of complaints by children or concerning the welfare of children, to check the satisfactory operation of the complaints procedure. In particular the complaints policy and procedures need to ensure adequate guidance is available to staff on the action to

p.10

Recommendations

take, and records they need to maintain, when a complaint is made about another part of the service (NMS 16.7) • ensure there is a system in place to notify within 24 hours the persons and appropriate authorities of the occurrence of significant events in accordance with Regulation 30. This is to ensure staff have adequate guidance regarding their responsibility when a young person makes an allegation to them about the service provided in another part of the organisations registered facilities (NMS 20.1) • ensure staff meetings address issues of control and agree practicable and acceptable means of responding to behaviour and control problems of both the current group of children and of individual children in light of their histories, any current problems and placement plans (NMS 22.16) • ensure that the education section of placement plans show how the home intends to support the educational attainment of children throughout the time they live there. It needs to

p.10

Recommendations

clearly reflect how the care team are supporting young people in their role as 'good parent' (NMS 14) • ensure that each child's file contains a copy pf their personal education plan (PEP) setting out a record of their educational achievements, needs and aspirations (NMS 14.2) • ensure that the placement plan for each child sets out clearly the assessed needs of the child, the objectives of the placement, how these will be met by the registered person on 10 of 11 Inspection Report: SC398253 a day to day basis, the contribution to be made by the staff of the home, and how the effectiveness of the placement is to be assessed in relation to each major element of the plan (NMS 2.1) • provide staff with training in the promotion of equality and diversity (NMS 31) • ensure there are effective systems in place to monitor the performance of the home. In particular there is a need to review the home's internal quality monitoring practices to

p.10

Recommendations

ensure they are sufficiently robust. (NMS 33.1) 11 of 11 Inspection Report: SC398253

p.11