Atkinson Unit

SC046276 Unique reference number 13 January 2010 Inspection date Malcolm Stannard / Linda Christie Inspector Key Type of Inspection

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22 September 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 12 Inspection Report: SC046276

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Brief description of the service

This Secure Unit is managed by a local authority. It is located in a residential area near to the city centre.

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Brief description of the service

The Unit is registered as a secure children's home and is approved by the Secretary of State to provide secure care and accommodation for up to 16 young people aged from 10 to 17 years. There are currently six young people resident at the unit of mixed gender, four of whom are placed on a welfare basis.

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Brief description of the service

Formal education for all the young people at the unit is provided on site. There is an indoor gym and sports hall, external recreation areas, a music room, garden and poly-tunnel for horticultural use and a vocational kitchen on site which are all available for use by young people.

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Summary

This was an unannounced 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 action and recommendations from the last inspection which took place in September 2009. The formal education provided on site was not inspected during this visit.

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Summary

Strengths of the unit include the healthcare provision which enables all needs to be identified and met proactively; the monthly planning of enrichment and meetings, and the life skills awareness sessions available to young people. Areas for development include consultation with young people and preparation for discharge from the unit. 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

There were eight recommendations and one action made at the last inspection in September 2009. Four of the recommendations which were made related to formal education at the unit and were not inspected on this occasion. The action and three recommendations have been addressed by the centre management.

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Improvements since the last inspection

Management at the unit were required to ensure that any allegations which may be of a child protection nature were referred to the local safeguarding children board. Since the last inspection all allegations of this nature have been correctly referred to the local safeguarding children board. This helps to ensure that young people are protected.

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Improvements since the last inspection

A review of the process by which agreement by managers to mobility plans was obtained was recommended. The procedure has now been amended so that permission is confirmed by a duty manager or team leader. This ensures that young people do not leave the building to undertake mobility without management approval and associated risk assessment. A recommendation was made that the structure to ensure exit plans are in place for all young people was to be formalised. This has been addressed and staff are reminding placing authorities of their responsibilities to ensure exit plans are in place, helping to ensure planning for young people. 4 of 12 Inspection Report: SC046276 A review of how the quality of staff formal supervision sessions was monitored was recommended. The registered manager now audits all records of staff supervision and will raise any concerns regarding the quality with individual staff and their supervisors. This helps to

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Improvements since the last inspection

ensure that staff who look after young people are supported.

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Helping children to be healthy

The provision is good. Significant progress has been made in relation to the food provided at the unit. The quality of food provided is good, healthy and nutritious. The menu has undergone a complete change following consultation with young people and health care staff. An individual menu is now available for each meal which includes choices and healthy options. All dietary needs are able to be met including any medical or cultural requirements. A separate kitchen is available for young people to use under supervision. This enables them to plan and prepare meals and learn about healthy eating. Healthy lifestyles are promoted; with young people being able to learn about food production.

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Helping children to be healthy

Good resources and practice are in place to promote good health in young people. Medical needs are assessed upon admission and an individual health care plan is devised from the information available. Appropriate medical consents are obtained and held on file. The plans are updated on a monthly basis and contain details of all health needs, including those which are carried out proactively. A final health information plan is made available to young people when they leave the unit, enabling them to ensure the health care they receive in the future will be appropriate.

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Helping children to be healthy

A nurse is available at the unit on a part time basis. Further support is provided by a GP who undertakes regular visits to the unit. External dental, ophthalmic and drug and alcohol misuse services are all able to be accessed by young people. The access to and quality of mental health input continues to develop. A quality improvement action plan for young people's mental health provision is in place. All young people receive a mental health assessment on admission. There is a large range of information regarding healthy lifestyles available for young people, who are also able to undertake first aid training courses. The health of young people is promoted.

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Helping children to be healthy

The system in place for the administration and storage of medication is robust. Written policies and procedures are available for staff guidance. The nurse is able to prescribe medication and the visiting GP is able to do so for controlled drugs. All shift leaders have received training in medication administration and medication management. Medication storage is secure and extremely well organised with regular checks being made of prescribed and non-prescribed stock. Records of administration are well kept and regularly audited. All staff members are trained in first aid and only trained staff administer medication. Young people's welfare is protected by the procedures in place for the administration of medication.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. The staff team respect young people's privacy and confidentiality. They receive relevant training. All personal information is handled and stored securely. Young people are able to make telephone calls in private. Windows in the bedroom doors are provided with privacy curtains and staff members make their presence known prior to entering rooms. 5 of 12 Inspection Report: SC046276 A system is in place which is understood by young people and enables them to make any concerns or complaints known. Young people can raise issues with a member of staff or there is a post box available in a communal area where written complaints can be left. Complaints forms are readily available and are also included in admission packs. Good records are held of investigation of complaints, outcomes and the response to the young person. Independent advocates also visit the unit and are able to speak freely with all young people. Young people

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Protecting children from harm or neglect and helping them stay safe

are confident that they can raise any concerns with staff and managers at the unit.

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Protecting children from harm or neglect and helping them stay safe

Staff members receive training in safeguarding when they commence work at the unit and undertake planned refresher training. Written guidance is available for staff to follow in the event of any allegation or disclosure. Any allegation which is made is referred appropriately to external child protection services and a record of all communication is held. A form which enables all relevant information to be recorded following a referral is available. This is not completed on all occasions and some tracking information can be lost. Young people are protected from abuse by the procedures and practice in place.

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Protecting children from harm or neglect and helping them stay safe

Staff undertake training in bullying awareness and are able to identify situations were bullying may occur. Individual and group work is carried out with young people regarding bullying, the form it can take and consequences. Records are held of any interaction which may be construed as bullying and all staff are made aware of the information. The practice helps to ensure that young people are protected from bullying.

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Protecting children from harm or neglect and helping them stay safe

Managers and staff work hard to ensure that young people are encouraged to display positive behaviour. An incentive scheme is in place which rewards young people for avoiding negative interaction and behaviours. Staff members use mediation and negotiation techniques when working with young people displaying negative behaviour. As a result there are comparatively low numbers of physical restraint incidents and sanctions. Restorative justice is used along with diversion and diffusion techniques. Good records are held of any behaviour management techniques which have been instigated and these are monitored by managers. Statistical information on the number of physical restraints is analysed to inform future practice and development. Debrief sessions are held following incidents to enable staff members to develop their individual practice.

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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. All tests of the fire alarm system and drills are recorded. Staff receive training in fire procedures and health and safety as part of their induction.

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Protecting children from harm or neglect and helping them stay safe

Young people’s safety and welfare are appropriately promoted by a consistently rigorous staff recruitment and selection process. An assistant manager monitors the local authority recruitment and vetting procedures and only signs these off as being acceptable when satisfied that all checks have been made. Young people are involved in the selection process for new staff.

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Helping children achieve well and enjoy what they do

The provision is good. Staff at the unit are supportive of individual young people's needs. They encourage young people's learning in education and there are good working relationships and communication 6 of 12 Inspection Report: SC046276 in place between care and education staff. Daily handover meetings are held which enable the level of support a young person may need to be clarified.

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Helping children achieve well and enjoy what they do

There is a good system of planning for activities and enrichment sessions. A monthly schedule is provided which details all sessions planned. Young people receive an individual copy of the plan so that they are able to see when they have any meetings or reviews coming up. The range of activities provided continues to increase and staff are motivated to offer activities. Enrichment weeks are also undertaken, these concentrate on an identified theme, such as learning about a particular culture or disability.

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Helping children achieve well and enjoy what they do

A good range of resources is available for leisure activities, including a fitness suite, sports hall, climbing wall and artificial outdoor sports surface. The unit has a music suite along with board and computer games, craft materials and books. External facilitators provide sessions such as sport coaching and movement to music and visiting sports teams are also invited to provide the opportunity for organised games. Young people are able to develop confidence in their skills and are supported and encouraged by staff to engage in activities that may be new to them.

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Helping children achieve well and enjoy what they do

The increased importance given to a structured enrichment and activity programme enables young people's continued development. The will to ensure that an activities programme operates and is sustainable provides a positive behaviour management tool which assists in reducing instances of negative behaviour.

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Helping children make a positive contribution

The provision is good. Relationships between staff and young people are generally very good. Staff have a good understanding of the identified needs of young people. Young people say they can talk to staff about personal matters and their aspirations for the future. They receive advice and practical assistance from staff to develop their skills and interests.

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Helping children make a positive contribution

Young people are well supported when they are admitted to the unit and staff make every effort to put them at their ease. Time is taken to explain to young people the expectations of them during their stay in the secure unit and what they should expect from staff caring for them.

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Helping children make a positive contribution

All young people have comprehensive assessments of need and there is a placement plan for each young person. These cover all aspects of the care provided and the targets to be addressed during their stay in the secure unit. The targets are realistic and achievable and agreed by all relevant parties including the young people.

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Helping children make a positive contribution

All young people are allocated key-workers on admission, who are expected to ensure all care needs are addressed. Key-workers hold a number of weekly sessions with young people to undertake direct intervention work. These sessions are closely linked to the targets set out in the placement plan. All case work is overseen by the acting deputy manager, who supports and advises key-workers in their role.

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Helping children make a positive contribution

Young people’s development and progress is reviewed regularly within the expected time frame. Young people confirm they can choose to attend their review meetings and are supported to do so by their key-worker. The views of young people and their families are actively sought 7 of 12 Inspection Report: SC046276 through the placement review process. An interpreter can be provided for any young person or member of their family with communication difficulties or for whom English is not their first language.

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Helping children make a positive contribution

Good quality detailed reports are prepared for the official review meetings and monthly update reports are written and shared with relevant professionals and parents as appropriate.

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Helping children make a positive contribution

Young people and staff are also very well supported by other professionals, such as the substance misuse service and the psychologists. Weekly meetings are held with the psychologists who visit the unit to review in detail the needs of the young people. They support staff in their work with young people and assist in the development of strategies to address complex needs and challenges.

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Helping children make a positive contribution

Consultation takes place with young people about the day-to-day running of the unit. This includes a weekly group forum meeting. However, the issues discussed at the group forum meetings do not provide a sufficiently robust process for consultation. At times the discussion appears to simply be about staff affirming rules and expectations with little evidence of young people making suggestions.

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Helping children make a positive contribution

Young people are encouraged and supported to maintain good contact with families and others of significance. Contact arrangements are good, young people are able to telephone friends and family subject to any restrictions. Families are encouraged to visit and young people say that their families are made welcome at the unit.

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Achieving economic wellbeing

The provision is good. Young people are well supported to prepare them for discharge back into the community or transfer to future placements. Good use is made of visits to future placements and invitations are made for staff from other resources to visit the young person in the secure unit. Staff work very closely with placing authorities to identify appropriate follow on provision for the young people, if required.

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Achieving economic wellbeing

There are good processes in place to prepare young people to develop independent living skills, although this is not consistently coordinated. Young people’s practical skills are assessed upon admission and they are encouraged to complete a wide range of workbooks and programmes to increase their life skills. Most of the young people complete modules of the Award Scheme Development and Accreditation Network, which include opportunities to learn practical skills such as; cooking, laundry and food hygiene. Personal hygiene and sexual health are also covered. Young people complete the modules at their own pace and several have obtained Bronze or Silver awards.

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Achieving economic wellbeing

The range of programmes used with young people during evenings and weekends to improve life skills and prepare them for adulthood has continued to increase. Young people are able to learn to cook, be involved in horticulture, care for chickens, and develop some basic maintenance skills. A parenting course is available for young people of either gender who wish to understand the responsibilities of being parents, including being given a ‘simulator baby’. 8 of 12 Inspection Report: SC046276 Young people are encouraged to consider the needs of others and are continually invited to raise funds for children’s charities, including African based projects, and support for children in the Philippines.

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Achieving economic wellbeing

Mobility trips outside of the secure unit are used well to assist young people in developing practical life skills, such as opening a bank account, visiting careers offices, using a library, and learning to shop on a budget.

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Achieving economic wellbeing

Although significant efforts are made to improve young people’s practical life and independent skills, examples of individual good practice arranged by individual key-workers are not pulled together to form a cohesive resettlement programme.

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Achieving economic wellbeing

Managers and staff remind placing authorities of their responsibilities to ensure exit plans are in place, and they commence this during an initial planning meeting. There is evidence of children’s service authorities being challenged when planning is not timely or comprehensive. However, on occasion further action such as alerting senior managers within the authority of their concerns is not undertaken.

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Achieving economic wellbeing

There are effective arrangements in place to ensure that all young people have appropriate clothes to wear and are suitably dressed. They are able to have a say in the clothes bought for them, or to shop with staff if risk assessed for mobility outside of the secure unit. Young people are provided with a monthly allowance for personal toiletries and have choice over the items available.

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Achieving economic wellbeing

Young people are able to personalise their rooms within the limits identified by any risk assessments.

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Achieving economic wellbeing

The building is well maintained and efforts are made to ensure as homely as possible an environment within a secure setting. There is a programme of ongoing development and plans are currently being drawn up for additional resources to improve vocational and independent skills training even further.

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Organisation

The organisation is satisfactory. There is a detailed statement of purpose which is well written, reflecting the ethos and principles which underpin the work carried out at the unit. There is a range of user-friendly information available to young people, their families and professionals involved with the work of the unit. There are recently published booklets, which have been professionally printed with illustrations.

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Organisation

Young people receive an admissions pack when they arrive at the unit. The pack contains essential information about day-to-day life and expectations, as well as information about advocacy and how to complain. A staff member is available to explain the contents of the pack and to help the young person familiarise themselves with the daily routine and procedures. A video is also available and this is in the process of being updated with involvement from the young people.

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Organisation

The only aspect of the work of the secure unit not included in the information booklets or the statement of purpose is the work done with young people to prepare for discharge and resettlement. 9 of 12 Inspection Report: SC046276 There have been further changes to the senior management team, with one assistant manager leaving. The management team currently comprises a secure unit manager, an acting deputy manager and one assistant manager, all of whom provide duty management cover, including evenings and weekends.

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Organisation

The secure unit reduced the number of young people it provides accommodation for from sixteen places to eight in September 2009. The staff team has now also reduced, with a number of staff either being redeployed or made redundant. Managers and staff have coped remarkably well with the changes and have continued to provide a stable environment and maintain a good quality of care and support. The reduction was as a result of contracting decisions with the Youth Justice Board and concerns about the viability of the secure unit. There was concern that the secure unit may close, but a decision has been made that this will now not be the case and an increase to provide ten places will take place from April 2010. The number of referrals for placements has been consistently high during recent months.

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Organisation

The frequency of staff supervision has fluctuated, but recently has improved to 85% being undertaken monthly. The quality of recordings and the monitoring of supervision records has improved considerably. The unit manager, performance manager and deputy manager now raise any concerns with relevant staff and their supervisors.

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Organisation

There is a good range of training and development opportunities for staff. A good programme of core training is in place for staff at all levels, but the next phase of building in the individual training needs of staff has yet to be addressed. This has been delayed because the county council has recently introduced a revised employee appraisal scheme and staff at the secure unit have not yet completed this in the new format. All but one of the care staff have achieved the National Vocational Qualification (NVQ) at level 3 in working with children and young people. All senior staff have either achieved or are in the process of completing the NVQ at level 4 certificate in management.

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Organisation

The induction programme for new staff is excellent. A comprehensive programme is available over a four week period. New staff shadow more experienced staff and complete the Children’s Workforce Development Council induction programme, which is a workbook based format and takes several months to finish.

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Organisation

There are sufficient numbers of staff to meet the needs of the young people, which includes appropriate management cover. Young people are cared for by staff who are competent to work with them and who are confident in their role.

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Organisation

There are good quality assurance and performance monitoring procedures in place. The performance manager and the duty manager have a good oversight of the records and are aware of events occurring in the unit. Evidence of shortfalls in practice are now more consistently being shared with relevant supervisors and managers.

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Organisation

The unit is monitored by the Regulation 33 appointed visitor who visits each month as required and completes a report on the visit. However, reports examined for the past three months do not reflect a consistently robust or systematic monitoring of records or practice. It was noted in the last inspection report that the complaints made by young people were not commented upon in the appointed visitor’s report. There is been no improvement in this respect. 10 of 12 Inspection Report: SC046276 Elected members have recently recommenced their quarterly monitoring visits to the unit, with one such visit taking place during the inspection.

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Organisation

A management board has recently been established which will meet every three months and will review a wide range of matters relating to the care and education provision in the secure unit. Monthly reports produced by the performance manager are now being shared with representatives of the board. Membership of the board includes senior officers from the children’s services authority, elected members, the head of a local school and members of the charitable trust that owns the site on which the unit is located. There has only been one meeting of the board, but this is a positive development and provides an additional monitoring process and a forum for supporting the work of the secure unit.

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Organisation

The individual care of young people is supported through good record keeping. The development and progress of young people are appropriately recorded to reflect their individual needs and circumstances. The files are detailed, appropriately monitored and include the necessary information required by regulation and good practice.

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Organisation

The promotion of equality and diversity is good. Staff and managers are sensitive to the individual needs of young people and this is reflected in records. There are arrangements in place to ensure that young people are supported to celebrate their religious faiths and develop their understanding and knowledge of other cultures and faiths. Several young people have decided to be baptised while resident in the secure unit. One young person was very positive about the support received from staff and the local minister.

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Organisation

There are positive images around the building that promote diversity and awareness of different cultures. A staff member taking a lead on diversity ensures that details about different religious festivals and other celebrations taking place each month are available in booklet form for staff, young people and visitors.

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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): • ensure all aspects of the process for making referrals to child protection services are completed on a consistent basis. (NMS 17) • review the format of the young people’s consultation meeting to ensure young people consistently have an opportunity to share their views about day-to-day matters in the unit (NMS 8) 11 of 12 Inspection Report: SC046276 • ensure a more consistently coordinated approach to preparation for discharge and resettlement (NMS 6) • ensure all staff have clear individualised personal development plans in place (NMS 31) • ensure that the appointed visitor conducting the Regulation 33 visits is consistently robust in the monitoring of practice, including checking records, which is then appropriately reflected in reports of the visit. (NMS 32) 12 of 12 Inspection Report: SC046276

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