Children's Home run by Crossway Services Limited in St Helens

SC068206 Unique reference number 29 April 2010 Inspection date Karen Forster Inspector Key Type of Inspection

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10 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 9 Inspection Report: SC068206

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Brief description of the service

This service is one of a network of children's homes maintained by an independent children's home provider. The home is a mid-terraced property that is situated within a mile of a town centre and all required shopping and leisure facilities.

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Brief description of the service

The home provides a placement for one young person, supported by a staff team of four. The home was occupied at the time of the visit and the young person and staff contributed towards the inspection.

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Summary

This visit is an unannounced key inspection covering all of the Every Child Matters outcome areas, plus an additional area of organisation. This is an outstanding service, where young people's strengths are celebrated and their needs are assessed and addressed. The service is clearly focused on the needs of the young people. Well motivated staff work extremely positively together to optimise outcomes for young people. This helps young people to develop their self-confidence and to exercise their developing life skills. One area for development is highlighted for the provider's attention, which relates to the training of all staff in the management of challenging behaviour. The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The last inspection raised one action in relation to the educational arrangements for young people in the home. Suitable educational arrangements have been developed by the provider, which means that this action has been completed. This means that young people can now access a three day alternative educational programme, and a home tutor for two days.

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Helping children to be healthy

The provision is outstanding. The young people enjoy a well balanced and varied menu. Individual food preferences are well recorded and closely followed within the home. This means that tasty food is suitably prepared and well presented in line with the choices of young people. Young people feel able to access drinks and snacks according to their wishes.

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Helping children to be healthy

Young people's current health care needs and a detailed medical history, are outlined in very clear health care plans for young people. The comprehensive plans also include clear strategies to address each

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Helping children to be healthy

individual's health needs. Key staff support young people in their attendance at primary and secondary health care appointments. This means that young people consult healthcare professionals for help and guidance. There is a clear focus on healthy living within the home. Daily exercise and physical activities, such as walking, cycling, football, and fishing trips are consistently completed by young people with staff support. 4 of 9 Inspection Report: SC068206 The individual with parental responsibility has provided signed consent for house staff to administer prescribed medication. Certain young people are confirmed as 'Gillick' competent, which means they have been assessed by a health professional as able to consent to their own treatment. Staff support and empower the young people involved to exercise this right. All of the staff are trained in first aid, which means that every shift is covered by a qualified first aider

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Helping children to be healthy

Medication storage and administration within the home meets the standards. The service provides a secure cabinet for items of medication dispensed by the community pharmacy. Medication administration records are very clearly maintained and staff operate a sound medication stock control and disposal system. This means that young people are offered medication in line with their medical prescription, and staff on subsequent shifts know when medication has been offered and administered.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. The home's personal care procedures promote the privacy and safety of young people. Staff are very careful to respect young people's privacy. Practice is consistently in line with the home's lone working risk assessment. This provides clear parameters for the one-to-one staffing support programme. This means that staff are clear regarding the permissible approaches and the level of contact with individuals, when working alone with young people. Personal data relating to young people is stored securely in line with internal policy and the required standards.

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Protecting children from harm or neglect and helping them stay safe

The home maintains an excellent procedure for the collection of compliments and complaints from service users, their families and other stakeholders. The active dialogue between staff, the young people's families and social workers is evidenced by the home's records of significant conversations. This means that any concerns are openly discussed and followed up by staff appropriately. Young people's concerns and complaints are consistently addressed or passed on by their carers. The details included within the home's complaints log demonstrate that comments are addressed and followed up well by senior staff, or designated professionals within the local authority's representations procedure.

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Protecting children from harm or neglect and helping them stay safe

Children’s safeguarding procedures are extremely good, with young people’s welfare given the highest priority. Staff confirm that they are aware of their responsibilities within the home’s child protection procedures. Staff also receive comprehensive safeguarding training. The local authority's safeguarding manual is available via an electronic link within the home. This facility complements the home's clearly written safeguarding policies.

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Protecting children from harm or neglect and helping them stay safe

There is an anti-bullying policy maintained within the service, where the stated aim is to manage any episodes of bullying and to prevent further incidents occurring. Peer pressure is limited within the home, due to the individual nature of the placement. Young people do not feel under any undue pressure from staff or their daily contacts. The home's records and manager's quality checks within the home support this assertion.

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Protecting children from harm or neglect and helping them stay safe

The home's protocol regarding young people going missing from care is highly relevant to the dependency levels of the service users. Staff members are clear regarding permissible measures to use in an attempt to stop young people leaving the home without authority. The home's policy is clear, meets the standards and staff are familiar with the content. This means that all 5 of 9 Inspection Report: SC068206 episodes of missing young people are taken very seriously, and are followed up with suitable responses.

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Protecting children from harm or neglect and helping them stay safe

Young people are supported to manage their own behaviour. This is achieved through the open communication between staff and individuals, and the staff team working closely together. Positive consequences are used consistently well within the group, to capture and celebrate positive behaviour. Young people receive individual and well planned staff responses to any presenting unacceptable behaviour. These positive approaches are included within young people's comprehensive behaviour management strategies. The young people make good use of regular opportunities to share their feelings with staff. This means that feelings of success, pride, frustration, confusion and worry, for example, are shared with trusted adults. This positive practice supports the home's culture of openness and the non-violent expression of personal feelings.

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Protecting children from harm or neglect and helping them stay safe

The home's policy regarding physical intervention meets the standards. All but one of the staff team have received recent instruction in the safe control of challenging behaviours. The preferred model of physical intervention includes de-escalation and only uses restraint as a last resort. This meets the standards and helps to keep young people safe. The home's procedure for recording restraints meets the requirements of the standards, and helps senior staff to monitor the use of physical intervention within the home.

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Protecting children from harm or neglect and helping them stay safe

The home ensures that the environment young people live in is safe and free of hazards, this helps young people to feel physically safe in the home. This sound level of health and safety within the home is achieved through the regular servicing of utility appliances within the premises, and close attention to fire safety risk assessment and risk management.

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Protecting children from harm or neglect and helping them stay safe

The home completes all of the clearance checks for new staff, as required by the regulations. The well-maintained personnel records carry the details of these checks, and demonstrate the robust recruitment programme in use in the home. This means that suitably cleared staff care for young people within the home.

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive a highly personalised care service which is very suitable to their needs and promotes their abilities. Staff work hard to address the care objectives outlined within the placement plan. This is achieved by staff maintaining a continuity of care, and a consistent relationship with the young people and their placing authorities. This means that all changes in presented needs are consistently shared, both within the staff team and between the service and family and involved professionals. The level of both verbal and written communication between staff in the home is sound. This means that staff are consistent in their approach towards individual young people. Therefore, young people enjoy consistent, safe care programmes that optimises their abilities and helps to further develop their social and self-help skills.

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Helping children achieve well and enjoy what they do

Young people and staff within the home work really well with professionals from an education network and home tutor service. This means that individuals access education and exam services suitable to their needs, and young people enjoy learning. 6 of 9 Inspection Report: SC068206

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Helping children make a positive contribution

The provision is outstanding. The strengths and needs of young people within the service are very well assessed and their medium and short-term care objectives are included within very detailed placement plans. This means that success is well celebrated and areas for further development easily identified and addressed. Detailed copies of the placing social worker's looked after child paperwork are well maintained, and are used to inform the care within the home. The internal placement plans are comprehensive and highly consistent with the contents of the local authority's documentation. This means that service users, commissioners and providers are clear regarding the aims of the placement and how the residential care element contributes towards the overall package of care.

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Helping children make a positive contribution

The care of individuals is independently reviewed, with a high level of involvement from young people and the presence of all relevant parties. This means that an external independent professional helps young people to reflect on their care. There is evidence within the home's records of young people's meetings, of the highly sensitive strategies utilised by the service to help young people reflect on their achievements and areas for development.

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Helping children make a positive contribution

Young people enjoy very close contact with their families and significant people, whilst they live in the home. This is evident by the home's log of contact between both young people and key staff with: family members; social workers; and a children's rights officer. This means that young people keep in touch with family members and significant individuals, which they value.

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Helping children make a positive contribution

The young people's records include very detailed pre-admission information, including individual risk assessments and previous histories. Relevant looked after child documentation is maintained within the home for reference and internal risk management strategies are agreed pre-admission, providing the home's staff with a wealth of highly relevant information to inform their safe care of individual young people.

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Helping children make a positive contribution

There are very well-developed strategies within the home for the involvement of young people in their placement plans and daily choices. The young people can recall visits and meetings with their social worker and children's rights officer, where they can make their thoughts and wishes known. There is consistent written and observational evidence, of the young people's thoughts and feelings being shared and valued by their carers. Young people really enjoy living within the home, and a very warm, caring atmosphere is observed between the young people and support staff within the service.

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Achieving economic wellbeing

The provision is outstanding. There is an extremely well-developed care planning system within the home. This enables staff to assess the young people's independence skills, and young people feel staff help them to develop new skills in this area. There is evidence of well written support plans for areas of self care, including diet and exercise, for example. Young people enjoy the use of their weekly pocket money, and learn how to manage their money.

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Achieving economic wellbeing

The home is well integrated into the local community, with no obvious labels or external signage. This means that young people see the house as their home, and can easily access all social aspects of the local community with staff support. Single bedrooms are provided for young 7 of 9 Inspection Report: SC068206 people, which are well decorated and highly personalised. The young people and staff have the use of communal areas that are highly comfortable, very domestic in style and suitably maintained. The home's external area is paved and provides limited space for recreation. However, the young people regularly make use of the local park, for exercise, and to play football for example.

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Organisation

The organisation is outstanding. The home provides a very clearly written Statement of Purpose which meets the requirements of the regulations. The young people's guide is extremely well presented, with excellent use of child-friendly language. This means that clear and accessible information relating to the service is available for stakeholders and interested parties.

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Organisation

The promotion of equality and diversity is outstanding. Young people benefit from the staff group's extremely well developed understanding and sensitive approach to their individual needs. Diversity and equality are promoted very effectively in all aspects of the service. This includes the quality and detail of young people’s placement plans, which enable carers to personalise the living environment for young people. The care practice within the service focuses on young people as individuals, where identity and heritage are well promoted and lifestyle choices supported. Young people's needs as adolescents are always considered, while staff have a very good knowledge of the impact of emotional difficulties on individual development. This means that young people enjoy growing up in the home, and are supported by a consistent and caring staff team to make informed life choices.

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Organisation

The home's staffing levels are very suitable for the resident young people and their care needs. Emergency back up is provided for home staff via the service's leadership team. This means that staff receive appropriate advice and support during emergency situations through both the day and night. The home provides a clear procedural guide for staff which confirms the provider's policies regarding such issues as safeguarding, personal care, medication and physical intervention. This means that staff can regularly refresh their understanding of these procedures, and their practice is in line with the company's guidelines.

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Organisation

All of the care staff within the home are qualified to the National Vocational Qualification at level 3. This is commendable and means that young people are cared for by competent staff, whose abilities have been verified by an independent body. Young people benefit from the close involvement of the qualified, well- experienced Registered Manager. The manager plays an extremely active part in the implementation of care programmes within the home. This means that the care of young people is positively influenced by the contributions of well-experienced and qualified junior and senior staff.

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Organisation

The home's comprehensive induction programme reflects the basic and specialist functions of the care staff role in the home. The specialist areas relevant to the service include such elements as attachment and empowerment. The positive level of training provided means that young people benefit from knowledgeable staff, who are confident and consistent in the application of specialist service procedures. The induction programme includes a well-implemented assessment of competence against a national standard for residential staff, provided by the Children's Workforce Development Council. 8 of 9 Inspection Report: SC068206 The quality of care is robustly monitored by senior staff members and provides comprehensive quality assurance reports to improve the outcomes for young people even further. The quality monitoring system is exemplary. This is due to the substantial element of external feedback from placing authorities and families, in addition to the feedback from resident young people.

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Organisation

The leadership team embraces all feedback provided by families, commissioners and regulators in a positive and balanced manner. This means that the leadership within the service is highly effective, as it moves the service forward and strives to maintain the best possible outcomes for young people.

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Organisation

The service maintains well-organised files, that contain all of the young people's records as required by the Children’s Home’s Regulations 2001. This means that both current and historical personal record information is available and readily accessible to young people and all authorised individuals within the home.

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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 that all staff have completed refresher training in physical intervention. (NMS 22) 9 of 9 Inspection Report: SC068206

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