Children's Home run by Choices 4 Children Limited in Lancashire

SC400880 Unique reference number 3 March 2010 Inspection date Debbie Foster Inspector Key Type of Inspection

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24 November 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 10 Inspection Report: SC400880

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Brief description of the service

This home is registered to provide care and accommodation for up to four young people of either gender, who are aged from four to 17 years. The home provides care for children with learning disabilities.

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Brief description of the service

The property is a converted farmhouse, set in 13 acres of grounds. It is located in a semi-rural area, but is within easy reach of shops, schools, public transport and various leisure and community facilities. Transport is available for young people to enjoy opportunities.

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Brief description of the service

There are four bedrooms on the first floor for young people in addition to their own bathroom. There are separate facilities and sleeping arrangements for staff members. On the ground floor there is an open plan lounge and dining room, a kitchen and a staff office. An enclosed garden with play equipment is situated to the rear of the home.

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Summary

This was an unannounced full inspection focusing upon 25 key national minimum standards (NMS) under the Every Child Matters outcomes for children and young people.

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Summary

The 10 actions and 10 recommendations made on the last inspection in November 2009 have also been checked to see if they have been implemented.

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Summary

Young people took part in the inspection process.

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Summary

The general health of young people is given importance in the home. There is a focus on supporting young people to attend health care appointments and their health needs. Overall, sound work is occurring to assist young people to keep themselves safe. However, not all safety risks for young people are specific to provide staff with full guidance on how to reduce or eliminate the risks where required.

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Summary

Staff have forged positive links with professionals to support young people. Young people benefit from full time education being in place. There is a basic care plan in place which identifies aspects of how an individual young person is to be cared for. However, the care plan is not always specific and detailed sufficiently.

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Summary

The home is decorated and furnished to a good standard, providing a domestic environment. Young people are consulted and involved in making some decisions about their lives.

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Summary

Staff have access to essential training and there is planned refresher training for staff in a number of areas in the next few months. This is to ensure all staff working at the home are up dated in current child care practices and in keeping young people safe. Staff receive regular supervision to support their development and assist in monitoring the welfare of young people. There are monitoring systems in place to check on how young people living at the home are being cared for. However, these have not been effective enough to pick up on all deficiencies and meet the regulations in full. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection. 4 of 10 Inspection Report: SC400880

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Improvements since the last inspection

The following actions and recommendations have been addressed from the last inspection.

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Improvements since the last inspection

There are suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home in particular in relation to controlled drugs. The menu record demonstrates the provision of a suitable and varied diet being provided to young people.

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Improvements since the last inspection

The home's safe guarding policy now details the actions staff should take in response to concerns raised should these involve a manager. This policy has been sent to the Local Safeguarding Children Board (LSGB) to be ratified and the home has made contact with the local authority designated officer. This is to assist in safeguarding procedures being followed and implemented. The behaviour management policy has been revised to reflect the current physical intervention techniques used by staff. Four fire drills, including evacuation of staff and children from the building and fire drills held at night, have taken place in a 12 month period in line with best practice. There is adequate lighting outside the home to ensure children and staff can enter and leave the home safely. The manager and provider have reviewed the system for making recruitment decisions in light of any concerns about applicants.

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Improvements since the last inspection

Young people's opinions are sought in a number of forums including the young people's meetings and appropriate topics are discussed.

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Improvements since the last inspection

The Statement of Purpose has been revised to include the required information about the registered provider. The manager has addressed issues found with one physical intervention used in the home, to ensure that no measure of control, restraint or discipline is excessive, unreasonable are be used on children accommodated in the home. The provider and the manager have addressed issues to ensure staff are fit to work in the children's home. The home maintains a system for monitoring the matters set out in Schedule 6, to support the improvement of the quality of care provided in the home.

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Improvements since the last inspection

The following recommendations are still to be implemented.

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Improvements since the last inspection

Suitable locks are not fitted to bathroom doors, to ensure privacy and that staff (not children) are able to open the doors to bathrooms, showers and toilets from the outside in case of an emergency. Not all risk assessments clearly set out the risks to the health and safety of children accommodated in the home, particularly the strategies for managing young people's behaviour. There are no comprehensive plans for young people preparing to leave care in place. This does not support them or takes into account their individual special needs in preparing them for adulthood or a smooth transition into a new home.

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Helping children to be healthy

The provision is good. A well balanced and nutritious diet is provided in the home and the menus reflect this. Young people's preferences, likes and dislikes are incorporated into the planning and cooking of meals. Staff are aware of the importance of promoting healthy eating and balancing this with likes and dislikes. Diverse meal options are included in the menu. Young people can help with tasks such as preparing food or washing pots and clearly enjoy sharing their pride with such 5 of 10 Inspection Report: SC400880 achievements to those around them. Young people's safety in the kitchen is fully considered and tasks are appropriate for their age and understanding.

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Helping children to be healthy

Young people's holistic health and medical needs are fully promoted in the home. Records support a range of appointments and contact with health professionals to ensure young people remain healthy and well. Specialist health instructions are clear on files and staff can demonstrate the care they provide. The manager is proactive in requesting appointments should need change and closely liaises with parents where this is appropriate.

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Helping children to be healthy

Medicines are administered, recorded and stored safely. Staff are trained in first aid and on how to administer medication safely to meet the needs of young people. Records for disposal of medication now evidence the amount of medication or the reason for the return to the pharmacist. The arrangements for the storage and recording of controlled drugs have been reviewed and meet current medical advice. The medication cabinet is secured to the wall.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. The young people's privacy is respected and staff demonstrate a clear understanding of confidentiality. The young people have their own bedrooms and they can choose to spend time there when they wish. Staff knock on bedroom doors before entering. They speak to young people with respect, by asking what they would like to do, eat for tea and within general conversation.

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Protecting children from harm or neglect and helping them stay safe

Staff demonstrate well their responsibilities to protect children from harm and they promote the children's welfare. Safeguarding procedures have been reviewed and updated since the last inspection to ensure full, safe arrangements and guidance for staff are in place.

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Protecting children from harm or neglect and helping them stay safe

All staff have received safeguarding training and they demonstrate an understanding of the procedures. The procedures are available for staff to refer to and use. Therefore, measures are put in place to keep young people safe and their welfare is promoted.

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Protecting children from harm or neglect and helping them stay safe

There is a clear policy and procedure on how to make a complaint. Young people know how to make a complaint. There have been no complaints made since the last inspection. When complaints are made there are recording systems in place which record the action taken and the full outcome of the complaint. This demonstrates that concerns raised are taken seriously.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected from bullying through the home's policies, procedures and the practice of the staff. There is information and posters on anti bullying. Young people told the inspector that bullying is not acceptable. Staff and young people said no bullying is occurring in the home.

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Protecting children from harm or neglect and helping them stay safe

Managing behaviour positively is important in the home and it is promoted and encouraged consistently by the staff team. Staff's approach to caring for young people is to have boundaries and positively reinforce good behaviour. The home's physical intervention policy has been reviewed and refers to the methods of physical interventions used by staff in line with their current training.

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Protecting children from harm or neglect and helping them stay safe

The staff are trained in care and control, which includes safe physical intervention methods. The staff rarely restrain young people and it is used as a last resort, which is good practice. 6 of 10 Inspection Report: SC400880 One sanction is recorded as being given to a young person and there has been no restraint incidents since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

The home provides good physical safety and security. For example, fire records indicate that regular checks on the system and appropriate fire instruction and drills have taken place. Fire drills have taken place at varying times of the day and night and involve the young people. However, fire safety training has not been provided at regular intervals for all staff to ensure they are fully up to date with all fire safety practices.

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Protecting children from harm or neglect and helping them stay safe

Risk assessments are in place for young people, which in the main cover the relevant areas in some detail and the supporting safety measures to be implemented with young people to keep them safe. These have been reviewed and updated since the last inspection. However, there are some shortfalls, not all explain clearly and specifically how staff are to reduce the risk identified.

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Protecting children from harm or neglect and helping them stay safe

Sound vetting and recruitment procedures for staff in place and meet the standards in most aspects. This is to support young people from being cared for by unsuitable staff. The recruitment files contain the majority of the required information and relevant checks on the person are undertaken, including the Criminal Record Bureau checks and references. However, there are unexplained gaps in one staff members employment history.

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Helping children achieve well and enjoy what they do

The provision is good. The young people receive individual support from the staff, and some professionals when they need it, to assist them to make progress in their lives. Staff demonstrate a good understanding of young people's individual needs, being aware of each young persons learning disability and other conditions. They have links with some health care and education professionals.

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Helping children achieve well and enjoy what they do

Education is actively promoted by staff. All young people attend school on a full time basis and this assists in them attaining their educational potential. Staff indicate that the young people's education is very important. They have regular communication with the schools and they attend school reviews. Each child has a personal education plan (PEP) that identifies their needs.

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Helping children achieve well and enjoy what they do

Young people are encouraged and supported well by staff to pursue activities. This develops their confidence and builds on their self esteem. There is a wide selection of games and outdoor play equipment for young people to use. Each young person chose what they wished to do before and after tea. For example, listening to music and using the computer. There is access to transport which the young people use to access activities in the community on a regular basis. Young people said they have lots of things they can do, going bowling, swimming, attending the local youth club, cycling and day trips out at the weekend.

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Helping children make a positive contribution

The provision is satisfactory. Young people's needs are assessed by the staff and supporting professionals. This is documented within individual plans of care. These outline what their needs are, including their likes and dislikes. Staff demonstrate how they provide care for young people and indicate the progress they are making. However, the plans do not set out clearly how young people are to be cared 7 of 10 Inspection Report: SC400880 for in all areas. They do not demonstrate the progress made by the young person and how they are moving positively forward in their life.

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Helping children make a positive contribution

Regular care reviews take place. Statutory review minutes are on the case files. This shows young people's care is being monitored.

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Helping children make a positive contribution

The home actively encourages and supports family contact. There is regular contact between parents, staff and young people. This is facilitated by regular phone contact and home visits which take place for individual young people.

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Helping children make a positive contribution

Young people are involved in decision-making adequately. There are positive relationships and good communication between young people and the staff. They interact together well, about how their day has been and what they would like to do whilst at the home. A young person said they like living at the home and like the staff. They are involved in making decisions about the food they eat, activities and family contact. Regular young people's meetings take place where young people have made suggestions which staff have acted upon. However, staff do not always demonstrate how they consult and involve them widely in decision making fully, for example within reviews or about their future.

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Achieving economic wellbeing

The provision is good. Young people are being well supported in developing practical independent living skills appropriate to their age and understanding.

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Achieving economic wellbeing

All young people are involved and undertake daily living tasks, such as planning the shopping list, preparing and cooking some meals, dusting and helping with washing up. They all help to keep their own bedrooms tidy and some process their own laundry. Support is also given to develop some budgeting skills with young people. Although the home is working with young people on independence skills, there is no formal pathway or transition plan provided by the placing authority. The home does not have a structured independence plan either to identify clear goals, targets and achievements for young people in this area.

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Achieving economic wellbeing

The accommodation is decorated and furnished overall to a good standard, providing a positive environment for the young people to live in. It is spacious with communal rooms for the young people to use. There are good outside facilities for play and recreation. The home is clean and tidy. Good repair and maintenance programmes are in place. A computer with internet access is available for young people, which they actively use.

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Achieving economic wellbeing

Bedrooms are well equipped with a good range of furniture. Two young people said they like their bedroom. Additional lighting has been fitted to the outside, along the path to ensure everyone can gain safe access to the premises at night.

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Achieving economic wellbeing

The decoration of the lounge was taking place at the time of the inspection. However, The bathroom facilities and decoration are showing signs of wear and tear. The provider commented there are plans to refurbish these areas. The types of locks on bathrooms are not suitable. Young people do not have a lockable facility or a lock with their own key for their bedrooms to promote independence and privacy. 8 of 10 Inspection Report: SC400880

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Organisation

The organisation is satisfactory. The Statement of Purpose informs others of what to expect from the home and how young people are cared for. This is to enable and assist in the appropriate admissions to the home and ensure individual needs can be met. This document has been reviewed in January 2009. The children's guide is in an appropriate format, using symbols and word and includes the relevant information.

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Organisation

Staff are supported and guided in promoting young people's welfare. They receive formal supervision at suitable intervals. There are regular staff meetings and daily handovers. Staff spoke about their work with young people with commitment and a caring attitude. All the staff team have completed the National Vocational Qualification (NVQ) at level 3 in caring of children and young people. Staff commented that they are supported by the manager and work well as a team. They said this assists them in providing consistent care to the young people. However, there is no designated person to take charge in the home in the absence of the manager and provider in line with the staffing policy. The provider stated this is currently being looked into.

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Organisation

Young people receive care from staff who can meet their needs. The afternoon shift was worked by two residential care staff and the manager worked a day shift to care for three young people. The people in these positions have relevant experience to undertake their duties. Shift patterns are still for long periods of time, most for 48 hours working in on shift. Staff said they are happy with these. Although this is through choice there are potential longer term implications which may impact upon the quality of care young people receive.

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Organisation

The staff have received training in the majority of current childcare practices to ensure they are competent to meet the needs of the young people. Staff have opportunities to undertake mandatory training in a number of areas, such as food hygiene, medication, child protection, autism and epilepsy. The home has refresher training planned in physical intervention, first aid and medication.

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Organisation

The promotion of equality and diversity is satisfactory. The staff team have received equality and diversity training and are committed to meeting the individual needs of young people and developing their experiences. Equality and diversity policies are in place and records show some examples of considering equality and diversity experiences and needs in plans.

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Organisation

Monthly monitoring visits to check how care is provided within the home are undertaken by the Registered Manager and the provider. These cover the areas set out in the regulations. However, these are jointly completed and do not detail any omissions and deficiencies that are being picked up on. The information recorded on checks carried out is brief, not indicating a robust approach to the monitoring of the service.

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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. 9 of 10 Inspection Report: SC400880

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Due date Action Standard

28 April 2010 ensure arrangements are made for all staff working at the home to receive training in fire prevention at suitable intervals (Regulation 32) 28 April 2010 ensure that suitable records are kept for the staff employed in the home which meet the regulations and include matters specified in schedule 2. In particular full employment history with any gaps explained (Regulation 26 (6) (a-d)) 28 April 2010 ensure young people's care plans set out clearly, how on a day to day basis they will be cared for and their welfare safe guarded and promoted (Regulation 12 (a)) 28 May 2010 ensure the monthly unannounced visit carried out by the provider and an individual written report is prepared on all the areas set out in the regulation (Regulation 33 ((3) (4) & (5)) 28 May 2010 build on the current managers monthly monitoring under regulation 34, schedule 6, to demonstrate what action is taken to address any identified short falls found. (Regulation 34,

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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 that all risks assessments specifically detail how the identified risks will be reduced or eliminated; in particular individual risk assessments are clear on strategies for managing young people's behaviour (NMS 26.2) • build further and demonstrate the consultation which takes place with young people (NMS 8.1) • ensure pathway and transition plans are in place and include all areas set out in standard 6.2; clear goals and targets must be in included within young people's plans to assist in demonstrating progress made in the areas identified (NMS 6) • ensure suitable locks are in place which enable staff (not children) to be able to open the doors to bathrooms, showers and toilets from the outside in case of an emergency (NMS 25.6) • ensure the bathrooms are decorated and furnished to a good standard (NMS 24 & 25)

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Recommendations

• ensure young people's bedrooms have appropriate locks fitted to doors and lockable facilities are in place (NMS 24.5) • ensure that there are clear arrangements for staff to deputise in the registered person's absence (NMS 29.2) • ensure that staff working extensive shift patterns are competent and able to meet the needs of the children. (NMS 21.1) 10 of 10 Inspection Report: SC400880

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