Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

SC033268 Unique reference number 23 March 2010 Inspection date Anne Bannister / Deborah White Inspector Random 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 7 Inspection Report: SC033268

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Brief description of the service

This 12 bedded children's home is one of three run by the company. The home is in a small village with a purpose-built school also on site. It is a detached house with its own extensive grounds. The home has access to a range of local facilities in a nearby town. It is registered for 12 young people, aged from six years to 12 years, of either gender, with emotional and behavioural problems. There are currently 10 young people on roll. Most young people have a statement of special educational needs, which provides for their additional needs. Young people living in the home have had disrupted schooling and are typically attaining below the expected levels for their age on admission.

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Summary

This unannounced interim inspection was used to follow up the actions and recommendations made at the previous inspection. In addition, the key standards for staying safe were also reviewed. Outcomes in being healthy; enjoying and achieving; positive contribution; economic wellbeing and organisation were not inspected. These outcomes will be looked at during the next key inspection.

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Summary

The outcome for promoting the safety and welfare of young people is judged as satisfactory.

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Summary

A number of issues have been identified where the home's documentation does not indicate that young people's welfare is adequately safeguarded by staff practice. Evidence that the use of sanctions is promoting positive changes in young people's behaviour is not clear.

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Summary

There are three actions and four recommendations arising from this visit. 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

Two actions and five recommendations were made as a result of the previous inspection. Both actions have been addressed. The school nurse has developed documentation which clearly records the outcome of any appointment attended by young people. Risk assessments of the building are now updated following any significant incident.

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Improvements since the last inspection

Three of the recommendations related to the use of sanctions. Two have been addressed. It is now clear that sanctions have been initiated during care or school hours. It is also clear that negative behaviours during education hours result in sanctions which are completed during the school day. Staff have still to develop the manner in which they assess the effectiveness of sanctions used to promote positive behaviours in young people.

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Improvements since the last inspection

It had been recommended that the home review the manner in which placement plans are written to ensure they effectively reflect all the work being undertaken with young people to meet their assessed needs and reflect progress they are making. Due to time limitation during the course of this inspection care plans were not reviewed. This recommendation will be followed up at the next key inspection. 4 of 7 Inspection Report: SC033268

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Helping children to be healthy

The provision is good. Not all key standards were judged under this section, so the good judgment, remains the same as at the last inspection. An action made following the previous inspection was followed up. The recently appointed school nurse has developed documentation which staff complete to indicate the outcome of any health care appointment. This ensures that all have up to date information which enables them to meet young people's assessed health needs.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. The staff team retain their commitment to ensuring young people in their care are protected from harm. However, deficiencies in records maintained have resulted in an overall judgement of satisfactory being given.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy is generally respected. There is only one shared bedroom in the home and the two young people in this room share by choice. Other young people benefit from their own individual rooms. However, none of the bedrooms have locks that they can secure to ensure their privacy. All toilets and bathrooms have fitted locks, but, although frosted glass is in place, there are no curtains or blinds on the windows. Staff knock before entering young people's rooms and there appropriate procedures in place for room searches. There is written guidance for staff in relation to the provision of personal care and includes guidance for bedtimes, being alone with staff, peer relationships and bath time. The guidance for staff in relation to bath times does not ensure that, as well as safeguarding young people, it also promotes their dignity. Some of the home's recording systems fail to protect private information adequately. They

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Protecting children from harm or neglect and helping them stay safe

contain detailed personal entries about individual young people which would be more suitably recorded on individual case records.

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Protecting children from harm or neglect and helping them stay safe

Young people know how to complain and there is good information about the home's complaint's procedure. Staff have had training to effectively manage complaints and information about access to an independent visitor is clearly visible in the home. Young people are also able to anonymously place any concern in 'a worries or suggestion box'. These are then dealt with by the responsible individual and a record of the action she has taken is displayed on the young people's notice board. Any incident were a young person has concerns about bullying are logged both in the complaints book and in the bullying log. Some of the records maintained in these logs insufficiently evidence that the actions taken to address issues raised by young people also fully address potential safeguarding issues. Examples of this relate to two incidents when young people's complaints may suggest inadequate staff supervision early in the morning.

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Protecting children from harm or neglect and helping them stay safe

Records maintained fail to show that the Registered Manager has discussed this with the staff team.

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Protecting children from harm or neglect and helping them stay safe

Since the previous inspection all staff have updated their safeguarding training. When safeguarding referrals are initiated they are well documented and provide a chronology of events. However, staff also maintain a log which evidences disclosures made by young people which are of an historical nature. (Please see comments about privacy above). The entries made in this record do not adequately reflect discussions held with placing authorities to confirm this is the case. 5 of 7 Inspection Report: SC033268 The home has a behaviour management policy which is consistently used by all staff. All staff are trained in safe restraint techniques and know under what circumstances a young person may be held. Good behaviour is rewarded and staff are observed to have positive relationships with young people. Inspectors were told that restorative justice techniques are used to help children understand how their behaviour affects others. However, these are inadequately

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Protecting children from harm or neglect and helping them stay safe

documented and records tend to focus on sanctions given in response to negative behaviour. In response to a previous recommendation the sanction log now clearly indicates whether a sanction was imposed during care hours or during education. However, records do not consistently indicate whether the sanction has been effective in promoting a positive response in young people's behaviours. Sanctions from education are not brought into the home for young people to complete. All physical interventions and sanctions imposed in response to unacceptable behaviours, are recorded and are monitored by the senior managers, to identify trends in behaviours and to ensure staff consistency.

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Protecting children from harm or neglect and helping them stay safe

The home has risk assessments in place for all aspects of the safety of the premises and grounds. However, a significant risk relating to a young person gaining inappropriate access to part of the building had resulted in risk assessments of this area being reviewed but the assessment not updated fully.

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Protecting children from harm or neglect and helping them stay safe

Young people are safeguarded by the home's policy for vetting visitors. Where adults are not known to staff, their identification is verified and the visitors book is signed so that the Registered Manager can monitor callers.

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Helping children achieve well and enjoy what they do

The provision is good. Not all key standards were judged under this section, so the good judgment, remains the same as at the last inspection. The Registered Manager advised inspectors that care plans have been revised and that under this outcome heading there is clear evidence as to how the care staff team are supporting young people's education in their role as 'good parent'. However, there was insufficient time to review care plans during the course of this inspection and this recommendation will be followed up at the next key inspection.

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Helping children make a positive contribution

The provision is good. Not all key standards were judged under this section, so the good judgment, remains the same as at the last inspection. A recommendation was made following the last key inspection. The Registered Manager indicated that it had been addressed. The home's care planning should now evidence all the work being undertaken to meet young people's assessed needs. However, there was insufficient time to review care plans during the course of this inspection and this recommendation will be followed up at the next key inspection.

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Organisation

The organisation is not judged. 6 of 7 Inspection Report: SC033268

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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

30 April 2010 ensure that the children's home is conducted so as to promote and make proper provision for the welfare of young people accommodated there. This relates to the maintenance of bullying and complaints records in a manner which indicate that consideration is given as to whether some issues raised by young people need to also be considered in terms of fully safeguarding their welfare (Regulation 11) 30 April 2010 ensure that written records are maintained of any allegation of abuse and of the action undertaken in response (Regulation 17). In particular this relates to issues currently logged in the disclosure book which relate to incidents which have been found to be of an historical nature, and are already known by placing authorities. 30 April 2010 ensure that risk assessments of the building are reviewed and updated when further advice has been obtained. (Regulation 23)

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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 private information is confidentially handled (NMS 9) • ensure that staff guidance on bathing young people promotes not only safeguarding but also promotes their dignity (NMS 9) • ensure that young people's right to privacy is not compromised by the fact they are unable to secure their bedroom doors (NMS 9) • ensure that staff consistently review whether sanctions given are promoting positive changes in young people's behaviours (NMS 22). 7 of 7 Inspection Report: SC033268

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