Children's Home run by Keys Education Ltd in South Gloucestershire

SC067561 Unique reference number 22 April 2010 Inspection date Barbara Davies Inspector Key Type of Inspection

p.1

31 December 2009 Date of last inspection .

p.1

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.

p.2

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

p.2

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.

p.3

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: SC067561

p.3

Brief description of the service

The home is registered to provide care for three children of either gender between the ages of 11 and under 18 years. It is a modern town house in an urban area. It is domestic in style with modern fixtures and fittings. The accommodation is spread out over three floors. The ground floor has a kitchen/dining room leading to a laundry equipped with washing machine and tumble dryer. A sitting room is equipped with television and DVD facilities. The first floor has a bathroom with toilet/shower/bath and whirlpool bath facilities. There are also two children's bedrooms located on the first floor landing and a staff office doubles up as a sleeping-in room. A second staff sleep-in room is located on the second floor in close proximity to a bedroom for a third child. The staff room is en-suite and bathroom facilities provided are the same as on the first floor. External features include a garage and small front and rear gardens. Shopping

p.4

Brief description of the service

and recreational facilities are within close proximity of the home and there are public transport links to the city centre. National rail links are also easily accessible.

p.4

Summary

This inspection was announced and looked at the key standards in each of the outcome areas. Actions and recommendations made following the previous inspection of the home in December 2009 were also followed up. These concerned improving the environment, ensuring a permanent and Registered Manager is in post and improvements to record keeping. These matters have all been addressed. Assurances have also been given that the pocket money system is currently under review. An excellent standard of accommodation is now provided and the home offers a safe place for young people to live. Management and leadership of the home is strong and this is complemented by a consistent and competent staff team. There are few incidents of going missing without permission and little use of sanctions and physical restraint. Young people respond well to the rewards system in place. This inspection has identified the need for

p.4

Summary

some minor improvements to other records that are kept. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

p.4

Improvements since the last inspection

Following the previous inspection, the provider was required to make improvements to the décor and furnishings throughout the home. Following a programme of refurbishment and redecoration, the home now provides accommodation of a high standard. The address to which young people are discharged is recorded in the admissions and discharge register. The manager has submitted an application to Ofsted and has been registered. A review is taking place of pocket money allowances in order to better promote the rights of young people.

p.4

Helping children to be healthy

The provision is good. The manager is aware of the need to promote a healthy lifestyle and is seeking to improve staff awareness of the issue. To achieve this the organisation is considering providing training for staff in the preparation and provision of healthy meals. Meals served provide young people with variety and achieve a good balance between the use of convenience foods and fresh ingredients. Staff encourage any young people with poor eating habits to try different meals. The involvement of young people in planning the menu allows them to influence what is served. 4 of 10 Inspection Report: SC067561 Their participation in shopping, preparing and cooking meals helps equip them for adulthood. Fruit, drinks and snacks are available for young people to help themselves to throughout the day.

p.4

Helping children to be healthy

A comprehensive health history, compiled for each young person, advises staff of any health issues and informs the planning of services. All young people are registered with local medical practitioners. They are supported to maintain good health by having routine checks with the dentist, optician and doctor. Specialist services are sought for young people who have particular health issues such as drug or alcohol abuse. For any child for whom it is considered necessary, referrals are made to the child and adolescent mental health services (CAHMS) in conjunction with the placing social worker and General Practitioner. The home also seeks to educate young people about maintaining a healthy lifestyle and precautions they can take to keep themselves safe. Young people say that the home is good at taking care of their health needs.

p.5

Helping children to be healthy

Current practice with regard to storage of medication in the home is consistent with the home's medication policy. Arrangements for the storage and administration of prescribed medication are appropriate. It is administered in accordance with the pharmacist's instructions and only to the young person for whom it is prescribed. The medication policy requires that homely remedies should not routinely be kept in the home. This means that potentially young people cannot seek prompt relief from pain for minor ailments such as headache or stomach ache without first consulting a doctor and receiving a prescription. This is not comparable with what would happen in most families. Should both young people require a homely remedy at the same time, the amount of medication stored in the home is unnecessarily increased, by this system. The policy also states that homely remedies may be kept in the home but does not specify the

p.5

Helping children to be healthy

circumstances in which this would be permitted or name the types of remedies permitted. The system for recording medication as it is administered is the same for both prescribed and non-prescribed medication. The format does not necessitate the reason for administration of homely remedies to be recorded or the dose. Information is therefore incomplete and does not inform staff whether a medication review is necessary.

p.5

Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people say that staff respect their privacy and do not enter their bedrooms without being invited. Young people have keys to their bedrooms which gives them free access, control over who enters and the ability to keep their possessions safe. Confidential information on young people and staff is locked in the office. Young people and unauthorised people are not allowed access to the office and staff are careful with the way information is managed. Young people are informed of their rights and know they can read information recorded about them.

p.5

Protecting children from harm or neglect and helping them stay safe

Young people are well informed about the complaints procedure that operates in the home and within their placing authority. Staff are proactive in dealing with concerns raised by young people, and this keeps the number of formal complaints to a minimum. Young people are satisfied that concerns are taken seriously although they may not always be satisfied with the outcome. Records are kept of most complaints made, although one notification received by Ofsted had not been recorded in the home's complaints record which means not all information is available to the people that monitor the practice of the home. Further investigation confirmed that the home has taken appropriate action in response to the matter. 5 of 10 Inspection Report: SC067561 The home trains staff in the child protection procedures to be followed in the event of a young person making a disclosure about abuse. Concerns about children's safety are appropriately

p.5

Protecting children from harm or neglect and helping them stay safe

referred to placing officers and to the local safeguarding board along with a request for a strategy meeting.

p.6

Protecting children from harm or neglect and helping them stay safe

Bullying is not reported to be an issue. Young people say they get along together although do not always want to do things together as they have different interests. Staff have strategies for dealing with bullying should it occur but receive no formal training. The focus on helping young people achieve positive relationships with each other and engaging them in activities successfully reduces the potential for bullying.

p.6

Protecting children from harm or neglect and helping them stay safe

Young people rarely go missing from the home but when they do, staff implement the home's missing person protocol and attempt to locate them and persuade them to return. A risk assessment approach is used to determine the length of time for which it is safe for a young person to be absent before reporting them as missing to the police. All necessary action is taken to ensure the safe return of a young person with social workers and family being kept informed of developments. On return young people are welcomed back to the home and consideration given as to whether the home remains a safe place for them to live.

p.6

Protecting children from harm or neglect and helping them stay safe

Overall, behaviour is well managed and incidents of physical intervention and sanctions are consistently low. Staff are trained how to hold young people safely should physical restraint be necessary. Young people say that sanctions given are fair and relevant to what has happened. A reward system operates and young people welcome this. The home is taking steps to ensure that the reward system operates entirely separately of the pocket money system to avoid confusion.

p.6

Protecting children from harm or neglect and helping them stay safe

A safe environment is provided for young people and staff. Staff receive basic training in health and safety and complete more comprehensive training in matters such as fire and food safety. Weekly checks on the fire alarm system and regular maintenance of mechanical equipment, such as boilers, ensures that all equipment remains in good working order and is safe. Young people take part in fire drills so that they know what to do in the event of a fire. Any activities in which young people participate are risk assessed and appropriate safeguards identified.

p.6

Protecting children from harm or neglect and helping them stay safe

Recruitment records were not inspected as part of this inspection. A separate inspection of records held centrally was conducted in August 2009. That inspection concluded that recruitment checks for permanent staff conform to regulations and determine whether people are suitable to work with young people. No agency staff have been used since the last inspection and it was therefore not possible to test the robustness of the newly introduced system.

p.6

Helping children achieve well and enjoy what they do

The provision is good. Staff support is consistently available to young people. Staffing ratios enable staff to spend time with young people. Staff retain an awareness of the group dynamics and whereabouts of young people throughout the course of a shift. They are always available to support young people in a crisis. A keyworker system provides young people with a named member of staff who will hold a bit more responsibility for caring for them than others. Young people can have dedicated time with their keyworker each week, to discuss and plan personal issues. External support, such as counselling and advocacy, is acquired for young people for whom it is an identified need. 6 of 10 Inspection Report: SC067561 Education provision is made in line with the assessed needs of young people. The organisation has its own school that young people attend if unable to attend schools in the local area. Staff encourage and reward regular attendance at school. The home maintains regular communication

p.6

Helping children achieve well and enjoy what they do

with schools to support children in their education and to help them make the transition from school to further education or employment. Personal education plans outline individual goals and targets and staff help young people achieve these.

p.7

Helping children achieve well and enjoy what they do

Leisure and recreational opportunities are promoted. Requests from young people are taken into account in the organising and planning of individual and group activities. Placement plans for some young people recognise the need for a full and structured programme of activities to help them make constructive use of their leisure time and prevent boredom. This however, has yet to be fully implemented.

p.7

Helping children make a positive contribution

The provision is good. The home assesses the needs of young people prior to admission and strategies for addressing these are broadly outlined within the home's own placement plan. More detail is required in some areas, such as preparation for independence and leisure activities, to demonstrate how the home is meeting the assessed needs of the young person. The practice of staff is not always consistent with the identified need of the young person. For instance, a full programme of activities was not in place for a young person for whom the placement plan has identified that this was an assessed need. This was observed to result in a high level of boredom. Placement plans are subject to regular review and are updated at least monthly to make sure they remain current.

p.7

Helping children make a positive contribution

The care that young people receive is subject to regular review by their placing authority. Reviews take place at the required frequency as a minimum. Reviews take place more frequently when there is an identified need, such as planning for transition. Staff consult and prepare young people for what is likely to be discussed during their review. This gives them the confidence to attend and participate. The staff have commenced making notes so that there is detail on file for staff and young people to refer to should there be a delay in receiving the official minutes from placing social workers.

p.7

Helping children make a positive contribution

Staff understand the importance of helping young people to maintain contact with their families. The arrangements for contact are agreed with placing officers when young people are admitted to the home. Young people confirm that contact takes place at the frequency agreed and that staff support them by providing transport and supervision if necessary. Staff help young people resolve disagreements with their family in order to help them achieve a more positive relationship with each other. Staff consult and involve young people about all aspects of their care. This often takes place informally rather than formally, as young people prefer this. Young people like the fact that they were consulted about the décor for communal areas and for their bedrooms. Staff use the weekly community meeting to involve young people in planning the menu and activities for the week ahead. The meetings also provide an opportunity for young

p.7

Helping children make a positive contribution

people to discuss any concerns with staff.

p.7

Achieving economic wellbeing

The provision is good. 7 of 10 Inspection Report: SC067561 Opportunities provided as part of the daily routine of the home help young people develop the skills required for adulthood. The ability for them to be involved in activities such as cooking, shopping and budgeting helps young people develop confidence in a non-threatening environment and with staff support. Individual placement plans broadly identify the areas where young people require additional knowledge and support such as managing own budgets and those of the house. The plans, however, do not provide sufficient detail about how this operates in practice, such as specifying the budgets concerned and the amount of money to be managed. The home is currently hindered in the progress it can make to help young people as some placing authorities have not yet forwarded copies of leaving care plans and pathway plans. Although this has been followed up with placing authorities, this was several months ago and

p.7

Achieving economic wellbeing

there is no evidence of the matter being pursued at a higher level.

p.8

Achieving economic wellbeing

The home is on a small, modern housing estate. It provides a high standard of accommodation with shops and leisure facilities being accessed easily by car or public transport. A programme of refurbishment and re-decoration of the property has recently been completed and this has enhanced the facilities. Young people like the improvements that have been made, in particular those that have been made to their bedrooms and the sitting room. The home is clean and tidy throughout. A good range of facilities in including television, DVD and digital photo-frame are available for young people to use. A shortage of crockery was addressed during the inspection.

p.8

Achieving economic wellbeing

A small garden to the rear of the property provides somewhere young people and staff can sit. The home has responded to requests from young people to use part of the garden to grow vegetables. This is helping inform young people about healthy eating.

p.8

Organisation

The organisation is good. Information describing the services and facilities provided by the home are published in two different formats. Information in the Statement of Purpose is updated regularly to reflect any changes that take place in the home so that it presents an accurate reflection of the care being provided. A simplified version is given to young people to inform them how they can expect to be cared for at the home. This is attractively presented and easy to read. The manager is aware that the service user guide is in need of amending to reflect some staff changes and to update contact details but has this in hand.

p.8

Organisation

Promotion of equality and diversity is good with young people receiving individualised care to meet their needs.

p.8

Organisation

Staff are well supported by the manager and by each other. Staff meetings take place monthly and staff now receive regular supervision on both a formal and informal basis. These forums provide staff with the opportunities to discuss practice issues and reflect on their own.

p.8

Organisation

The home is staffed at all times by staff with sufficient experience and qualifications and who are confident in their role. The manager has recently been approved as Registered Manager. She is currently working towards an appropriate childcare and management qualification. She works in the home in a supernumerary capacity and works mainly during the day. She is therefore readily available for young people and staff to talk to.

p.8

Organisation

The home provides a stable and settled environment for young people. Concerns expressed by young people at earlier inspections, concerning the persistent movement of staff between 8 of 10 Inspection Report: SC067561 homes, have now been resolved. Shifts are mainly staffed by the home's own permanent staff and levels of staff sickness are low. Although shifts worked by staff are long, this brings some benefits to the young people. Planning of activities is easier and continuity and consistency of care is provided.

p.8

Organisation

The home's training strategy equips staff with the skills and knowledge to work with young people. Staff new to the role receive a comprehensive induction to familiarise them with their roles and responsibilities. Core training such as safeguarding procedures, safe hold techniques and food safety is provided to staff during induction and repeated at specified intervals to ensure that their knowledge remains current. There is an expectation that staff will complete National Vocational Training at level 3 on completion of their induction.

p.9

Organisation

A robust system is in place for monitoring the practice of the home and ensuring that the welfare of young people is safeguarded. The manager conducts a monthly audit of records to make sure that staff are fulfilling their role correctly. The audit does not currently include records of recruitment so the manager is not able to demonstrate how she confirms that staff are suitable to work in the home. The external line manager also visits the home at least monthly to conduct a quality assurance audit. The audit includes talking to staff and young people to obtain their opinions of what it is like to work and live in the home. Reports are completed of both matters and these identify any issues that require attention.

p.9

Organisation

The home keeps all the records required but some minor issues are noted in their composition and accuracy. The register of staff still refers to the former company that ran the home, the log book does not note the staff who are on the rota to work each day and log entries refer to staff by initials and not using their full names. The full signature of staff is also not recorded after each entry. These shortfalls would make it difficult to identify staff if a complaint is made in the future. The duty roster does not show movements of staff between homes; it is therefore difficult to identify any patterns that occur.

p.9

Organisation

Case files are kept for young people in which their progress is recorded. Files contain all the background detail required which enable the home to plan an effective care package. The monitoring process is good at identifying when placing authorities fail to forward essential information to the home, such as leaving care and pathway plans. Written requests are made to placing authorities in an attempt to secure missing information but copies of these are not always placed on the file of the young person concerned. They would therefore not have access to all information recorded about them.

p.9

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.

p.9

Due date Action Standard

30 June 2010 ensure that more detail is included in placement plans describing the day-to-day strategies being used to care for 9 of 10 Inspection Report: SC067561 young people, particularly in relation to preparation for independence and activities (Regulation 12) 30 June 2010 ensure that suitable arrangements are in place for the recording of medication administered - this relates to ensuring a suitable system is in place for recording the administration of homely remedies (Regulation 21 (1)) 30 June 2010 ensure that a written record is made of any complaint (Regulation 24(5)) 30 June 2010 ensure a copy of the staff duty roster of persons working at the children's home is kept, and a record of the actual rosters worked (this refers to updating of staff rosters to accurately reflect the changes made when staff are required to work shifts in other homes). (Regulation 29(1))

p.9

Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure that a written record is kept by the home of all medication given to children which includes the reason for administration (if not prescribed) (NMS 13.2) • ensure that the home contributes to the development of the Pathway Plan for young people and works collaboratively, where appropriate, with the young person's personal adviser in implementing the plan. (NMS 6.3) 10 of 10 Inspection Report: SC067561

p.10