Children's Home run by Headway Adolescent Resources Limited in Bristol

SC066250 Unique reference number 19 January 2010 Inspection date Wendy Anderson Inspector Key Type of Inspection

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24 August 2009 Date of last inspection .

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 9 Inspection Report: SC066250

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Brief description of the service

This service is a three-bedded children’s home for young people of either sex who are aged 11 to 18 years. It is located in a post-war house in a residential area. The home is decorated and furnished to a high standard. There is a pleasant garden to the rear of the building. The home is a short walk to bus services for the city centre. All shopping, utilities, essential services and schools are located in the nearby area.

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Summary

This was an unannounced key inspection with all the key standards being inspected. The home is well managed and staffed by an experienced well trained staff team. Staff provide the young people with a safe, supportive, nurturing environment. Young people are able to contribute to their care and the running of the home. Young people's health needs are well met including providing support to young people to attend health appointments. Education is seen as a keystone to the young people's development. The home provides in-house tutors and supports young people in school and college. The home has robust policies and procedures which the staff have a good working knowledge of.

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Summary

There are several shortfalls identified at this inspection. These are that staff do not consistently receive supervision or appraisal at the required intervals, a lack of evidence of the emergency lighting being tested as required and a lack of evidence to support the fire awareness training provided for staff. The regulation 33 visits do not consistently happen at the required intervals and the majority of these are announced rather than unannounced. The managers monitoring is through but does not include the monitoring of the homes work against its statement of purpose. 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

Since the last inspection the home has recruited a number of experienced staff which has lead to a vast decrease in the number of bank staff being used thus improving consistency of care. The home has also held night time fire drills as part of its fire drill schedule.

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Helping children to be healthy

The provision is good. The menus at the home are varied and well balanced. The home has a main menu and individual menus for each young person. Individual menus reflect what is actually eaten. Young people said that they were involved in compiling the home's menus and are encouraged to take part with staff in the preparation of meals, which they enjoy. Young people who are working towards independence are supported by staff in menu planning, budgeting and shopping.

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Helping children to be healthy

The home has records of fridge and freezer temperatures. These also contain any actions taken to ensure that the fridge or freezer remains within the recommended temperature range but this is not consistent. One of the homes freezers is operating well below the recommended range. This could lead to young people consuming food which is not appropriately stored. 4 of 9 Inspection Report: SC066250 The young people are registered with a GP and a dentist and routine check-ups take place. Evidence of this was seen on the young person's file. Young people said that they attend health appointments and staff support them in this.

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Helping children to be healthy

Young people's individual files contain all the required medical information. This includes all medical appointments as well as any specialist medical or therapeutic input a young person is assessed as needing. They also contain consent forms for first aid, emergency medical treatment, administration of prescribed and non-prescribed medication.

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Helping children to be healthy

Medication is appropriately stored and administered. Records show that staff are trained in the administration of medication. Records of medication administered are clear and comprehensive. Where young people self-medicate the GP is consulted about the possible risks involved of a vulnerable young person self-medicating with the drug being currently prescribed. The home also carries out a risk assessment.

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Helping children to be healthy

The home has an appropriate accident record and a copy of this is retained on the young person's individual file.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people’s privacy is respected by staff. Young people supported this view saying staff always knock on their bedrooms doors and wait before entering. Bathrooms and toilets are fitted with the appropriate locks. The home has an appropriate room search policy and procedure in place.

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Protecting children from harm or neglect and helping them stay safe

The home has an appropriate complaint policy and this is known to all staff and young people. There is also clear information in the young persons guide on how to make a complaint. Young people spoken too were clear on how to make a complaint and say they feel the staff listen and respond quickly to any concerns they have. The home’s record of complaints received was seen. These were correctly recorded and complaints listed were seen to be responded to in an appropriate manner.

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Protecting children from harm or neglect and helping them stay safe

The bullying policy is well written and staff and young people spoken to knew the process to be followed should an incident of bullying occur. The young people spoken to said that bullying was not an issue within the home. They said they were confident that if any bullying did happen they would speak to staff and staff would sort things out. Young people say they felt staff listened to them and took what they said seriously.

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Protecting children from harm or neglect and helping them stay safe

The child protection policy and procedure is clearly written and staff received training in child protection as part of their induction process. There are also on going refresher training courses on child protection for all staff. Staff interviewed were clear on this policy and procedure, and on what action they would take. These systems ensure that young peoples welfare is safeguarded.

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Protecting children from harm or neglect and helping them stay safe

All young people have an individual behavioural plan. This identifies possible behaviours, potential triggers, de-escalation techniques to be used, and the level of physical restraint to be used. There is also detailed risk assessments on individual young people. These clearly identify risks, the level of risk and to whom and methods/action to reduce such risk. These are reviewed and updated weekly. 5 of 9 Inspection Report: SC066250 Records of incidents requiring physical restraint or sanctions are correctly recorded. Providing a robust audit trail with clear descriptions of the behaviours which lead to the restraint or sanction. These also record the effectiveness of the restraint or sanction and the young people’s views. Both the sanction and restraint logs are regularly monitored by the manager and the regulation 33 visitor. All staff are appropriately trained in the home's preferred method of restraint, Prevention, Assessment and Management of Violence and Aggression (PAMOVA).

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Protecting children from harm or neglect and helping them stay safe

The incident log at the home is clear and detailed. The home has the appropriate record of young people absent without authority. Where absconding has been identified as an issue for a young person the home carries out a specific risk assessment on this and there is clear evidence of this being put into operation. The home has a good relationship with the local police. The manager said that when called the police attend promptly. These systems ensure that young peoples behaviours are appropriately addresses.

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Protecting children from harm or neglect and helping them stay safe

The home has alarms fitted to the bedroom doors at the time of inspection these were not in use. The home's Statement of Purpose clearly details the policy and process for using these alarms, which includes a risk assessment.

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Protecting children from harm or neglect and helping them stay safe

The home has reviewed its recording of fire precautions which includes drills, equipment tests and staff training. These are comprehensive with the exception of a record of emergency light tests. There are significant gaps in the testing of the emergency light system and no evidence of the emergency lights being subject to and extended test of approx three hours. The fire risk assessment is comprehensive and includes the sites of all fire fighting equipment, exits, emergency lights and call points. Young people say they have frequent fire drill at different times of the day so are clear on what to do if the fire alarms sound. There is a lack of evidence of staff receiving formal updates to their fire awareness training. The manager said that during a staff meeting all staff watched a fire awareness training video but there was no evidence to support this. However staff interviewed were clear on what actions to take should the alarms

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Protecting children from harm or neglect and helping them stay safe

The home has risk assessments for the premises including individual rooms. The home has an appropriate health and safety policy and procedure which they adhere to. The portable appliance testing of electrical equipment is only just overdue but a date has been arranged for this. This system ensures the young people live in an environment free from hazards.

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Protecting children from harm or neglect and helping them stay safe

The home has a robust recruitment and vetting process for new staff to ensure young people are protected. During this inspection three staff files were inspected. All contained all the required information regarding vetting and recruitment. The home visitor book is well maintained.

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Helping children achieve well and enjoy what they do

The provision is good. The home operates a key work system with designated key workers for each individual young person. The key workers meet with their young person on a weekly basis. These sessions are recorded and the notes from the previous session are revisited. Part of the key worker role is to produce weekly summaries for placing social workers including a review and update of young people's risk assessment. Young people spoken to say they found these sessions valuable and they felt that the key worker relationship was important to them. There was evidence in the young people's files that access to specialist services is arranged, for example, psychiatrist and 6 of 9 Inspection Report: SC066250 psychologist assessments via the GP which are then referred to the child and adolescent mental health team as appropriate.

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Helping children achieve well and enjoy what they do

The home is very focused on ensuring that all school aged children receive a good level of education. The home continues to offer formal educational opportunities even when faced with opposition from young people in attending education. The agency employs the services of one part-time teacher who provides in-house tutoring on the premises. There is a well-equipped education room in the home.

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Helping children achieve well and enjoy what they do

The home arranges a wide range of leisure and recreational activities. Young people say that they are able to put forward ideas on what they want for activities and where possible staff put these in place.

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Helping children make a positive contribution

The provision is good. Young people placed at the home have care plans in place which showed that an assessment of need has been carried out. Young people's reviews happen at the required intervals. Young people spoken to say they knew what was in their placement plans and were always involved in their reviews. This could be by attending the review or working with an advocate or a member of staff to produce their own report for the review. Young people felt that their views were listened to and where possible acted upon at their reviews. Young people say that staff spend time with them after the reviews to go through the review meeting minutes.

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Helping children make a positive contribution

Young people have weekly house meetings. These meetings have an agenda which the young people contribute to and are recorded. The minutes of these meetings also record when the young people refuse to take part in the meeting. Young people spoken to say these meetings were good at getting things sorted out. Due to the small size of the home additional consultation takes place on an informal and ongoing basis.

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Helping children make a positive contribution

The home enables young people placed with them to maintain contact with their families and friends. Young people have access to the internet which has the appropriate safeguards in place. The home monitors all internet access to ensure the young people do not access inappropriate sites.

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Helping children make a positive contribution

During the inspection the conversation between care staff and young people appeared friendly and jovial. Staff address young people with respect. Young people said that they had good relationships with staff. They felt that staff looked after them very well and the young people said they enjoyed spending time with the staff. Young people said that they did not know what they would have done without the support of the staff team.

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Achieving economic wellbeing

The provision is good. The home has a warm and welcoming atmosphere. All parts of the interior of the building were decorated and furnished to a good standard. The bathroom and toilet facilities ensure privacy and are of a good standard. The garden has an array of plants and shrubs which are well cared for. There is a summerhouse and a large garage. There is an abundance of games, books and recreational facilities within the home. Young people say they liked their bedrooms and were able to personalise them. Young people say that the staff make it feel like home. 7 of 9 Inspection Report: SC066250 Young people have clothing and personal needs allowances. These they are able to spend on items of their own choice. There are appropriate records kept of these monies, with copies placed on the young person's individual file.

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Achieving economic wellbeing

The home has a robust admission and discharge policy and procedure, which includes the taking of emergency admissions. The manager is fully involved in this process and there was clear evidence of the manger refusing to take admissions as they were not appropriate in light of the current placements. Staff also provide support for young people once they have left where a need had been identified. The home maintains an admission and discharge register for all young people placed which contains the appropriate information.

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Organisation

The organisation is good. The home has an appropriate Statement of Purpose which sets out the work the home will undertake with the young people being placed there. There is also a guide for young people which is produced in a young person friendly format. These are reviewed on an annual basis. Young people said that they found this helpful when they were admitted.

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Organisation

The home is well managed and staffed by a competent staff group who are sufficient in number to meet the needs of residents. At the time of inspection there had been a significant number of new staff recruited. This means that at this time the home does not have 80% of its staff team have not gained the National Vocational Qualification at level 3. However these staff have been enrolled on this course. This recruitment has lead to a vast drop in the number of bank staff the home uses. The home has a good range of experience, skills and gender within the staff team. Staff training has a high profile in the home. Staff are encouraged and supported in their training needs and interests. There is clear evidence to support this on staff files. The staffing rota was seen which showed that there are always two staff on duty at night but usually three on during the day. The staff rotas incorporate handover times and team meetings.

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Organisation

Staff supervision and appraisals at the home is not consistently happening at the required intervals. Where these have taken place there are clear notes and the sessions cover the required topics. The staff interviewed said they felt well supported by the manager and their colleagues.

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Organisation

Within the files of a new member of staff there was evidence of a comprehensive staff induction programme in place which showed that they were being trained in all key areas of care work. New staff say that they have found the induction process very good and feel that it prepared them well for the work they do.

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Organisation

The home has staff meetings every week. These meetings look at individual young people, development of the home and any other related issues. These meetings have agendas to which the staff team are encouraged to contribute to.

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Organisation

The home is well monitored by the manager and the provider. Within the home's records there is clear evidence to support this monitoring. The regulation 33 visits are not consistently carried out at the required intervals and the majority of this are announced. These reports are well formatted and give clear guidance to staff on action required and are discussed at the weekly staff meetings. The manager carries out monthly regulation 34 monitoring of the home's work. This does not include monitoring the home work against the homes statement of purpose. The home also carries out three monthly quality assurances with the social workers and other 8 of 9 Inspection Report: SC066250 professionals who work with the home. These evaluations were very positive about the work the home does. These included good communication skills, promoting contact with young people's families, meeting young people's identified needs and keeping these needs under

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Organisation

review with amendments where required and receiving clear and concise updates on a weekly basis.

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Organisation

Young people’s files contain all the required information.

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Organisation

The promotion of equality and diversity is good. The home's commitment to equality and diversity is reflected in all the home's policies. The comprehensive care planning and identification of individual needs coupled with the detailed knowledge the staff have of the young people they care for ensure young people receive a good service and have their needs met. Staff receive training in equality and diversity.

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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

31 March 2010 ensure emergency lighting tests are carried out at the required intervalsincluding the extended emergency light test and recorded (Regulation 32 (a)) 31 March 2010 ensure staff training on fire awareness is recorded (Regulation 32 (d)) 31 March 2010 ensure staff consistantly recieve supervision and apprasials at the required intervals (Regulation 27) 31 March 2010 ensure Regulation 33 visits happen at the required intervals and that the majority of these are unannounced (Regulation 33) 31 March 2010 ensure Regulation 34 reports include monitoring the homes work against the statement of purpose. (Regulation 34)

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Recommendations

There are no recommendations. 9 of 9 Inspection Report: SC066250

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