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

SC386003 Unique reference number 21 April 2010 Inspection date Anne Bannister Inspector Key Type of Inspection

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11 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: SC386003

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Brief description of the service

This four bedded children's home, is one of three run by the company. It is a detached house with its own front and rear garden areas. The home has access to local facilities and provides accommodation and care for four young people of either gender, aged 12 years to 16 years. Single bedroom accommodation is provided for all young people. The service provided is primarily aimed at young people who have lived in one of the other homes registered by the company and who have been unable to return to families or foster families before their 13th birthday. The home has been established to ensure consistency of care to young people and to ensure they develop life skills for independence.

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Summary

This was an unannounced key inspection and so all the key national minimum standards were assessed. Three actions and one recommendation were followed up from the previous inspection. Aspects of the care provided to young people are judged as good.

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Summary

Young people's assessed needs are met by staff who have developed strong, positive relationships with the young people and their carers. Young people spoken to are positive about the care they receive in the home.

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Summary

Young people are encouraged to develop healthy lifestyles. The practices implemented within the home ensure that young people's health and dietary needs are well met. The life skills used within leisure activities assist young people to develop skills, which will support their independence and link into planned education programmes.

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Summary

Where actions and recommendations have been raised, they relate to inadequacies in documentation that fails to fully evidence the good practices implemented by staff when working with young people. 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

The home has addressed the three actions and one recommendation raised following the previous inspection. These have been fully assessed under the key standards for keeping young people safe. Two actions and the recommendation related to the need to meet Fire Authorities Regulations. The third action concerned the need to ensure staff refresher training in behaviour management techniques was maintained within the required frequency. All staff have now updated their behaviour management training

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Helping children to be healthy

The provision is good. The health and well-being of young people is closely monitored. Menus offer young people access to a balanced, healthy diet and all young people spoken to confirmed they are involved in planning the menu 'we help plan what we eat but if we ask for lots of junk food it is explained why we cannot always have it'. All care staff have received certificated food hygiene training, 4 of 9 Inspection Report: SC386003 ensuring they are aware of safe working practices and procedures to follow when preparing food for young people.

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Helping children to be healthy

All staff are trained in first aid to ensure an efficient and appropriate response to any minor injuries, and in the safe administration of medication. Signed consent is also on individual files. Each young person's file also contains information specific to the young person's health needs. The home ensures that specialist support is provided to address young people's identified health care needs.

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Helping children to be healthy

The home operates procedures that comply with the administration and safekeeping of medicines. These are effectively monitored by the Registered Manager and by the school nurse. All staff have received formal training in the safe storage, disposal and administration of medication, ensuring that they are aware of appropriate procedures to follow.

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Helping children to be healthy

These actions show young people's health needs are well met.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Overall the arrangements in place to promote the welfare and safety of young people are good. The staff team are highly committed to ensuring that young people in their care are protected from harm. The young people's privacy is respected. This is clearly evident in how the daily routine is managed and how information is shared and recorded between staff.

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Protecting children from harm or neglect and helping them stay safe

Reporting of safeguarding incidents complies with local safeguarding procedures and the Ofsted protocol for reporting significant incidents. However, records relating to incidents are currently logged in a number of different documents. When read collectively these documents provide a full account of the progress of a safeguarding referral. Staff receive annual safeguarding training to ensure their practice continues to promote young people's safety. Arrangements for complaints, bullying and behaviour management are handled well and ensure that young people feel listened to and protected. Bullying has been an issue within the home and staff are consistent in their response to addressing the issues and working with all young people involved to alleviate the problems experienced.

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Protecting children from harm or neglect and helping them stay safe

Young people going missing without permission is not an issue at the home. The home has policies and procedures in place, detailing action for staff to take in any instances of such behaviour by young people. These procedures have recently been revised in consultation with the local community police officer.

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Protecting children from harm or neglect and helping them stay safe

Risk assessments are produced to highlight concerns and vulnerability. Detailed behaviour management plans are produced to support staff practice. Staff are competent in supporting the young people's needs. All staff are trained in methods and techniques of physical intervention. Since the previous inspection all staff have updated their training. Staff endeavour only to use physical intervention in extreme circumstances, preferring to use their skills in de-escalation to try to support young people experiencing difficulties. Behaviour management plans and risk assessments are agreed as part of placement planning arrangements. Accurate records are produced on all incidents and events. Documentation has been developed to ensure both staff and young people reflect on their actions following any incident. This ensures the continued safety of both young people and the staff team working in the home. 5 of 9 Inspection Report: SC386003

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Protecting children from harm or neglect and helping them stay safe

There are sufficient baths, showers and toilets, to fully meet the needs of the of young people who may be accommodated at any one time. Doors on all such areas have suitable locks fitted, to afford privacy for those using them. All hot water taps used by young people have temperature regulators fitted to them.

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Protecting children from harm or neglect and helping them stay safe

Evidence and observation shows that the home has a responsible attitude towards health and safety matters. The home has risk assessments in place for all aspects of the safety of the premises and grounds. Appropriate risk assessments relating to young people's behaviours and planned activities are in place. These risk assessments are regularly reviewed and updated to ensure young people's continued safety.

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Protecting children from harm or neglect and helping them stay safe

Actions raised in the previous inspection report relating to the fire risk assessment, testing of equipment and frequency of fire drills have all been addressed. Fire risk assessments, fire alarm tests and fire safety equipment checks are up to date. However, the home's fire risk assessment does not indicate the responsibility of shift leaders to remove any wedges that are propping open fire doors during day time hours. All gas and electrical appliances receive an annual check. Overall the home's actions show that there is a commitment to ensuring young people live in a safe and secure environment.

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Protecting children from harm or neglect and helping them stay safe

Visitors are welcomed into the home once they have satisfied staff of their identity and the purpose of their visit, and have signed the visitors book. In relation to all other aspects of their care the home takes all reasonable measures to ensure young people live in a safe environment.

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Protecting children from harm or neglect and helping them stay safe

Recruitment files examined indicate that the organisation operates appropriate recruitment procedures that meet with the requirements of the Children’s Homes Regulations 2001. All required pre-employment checks are carried out and staff recruitment records are well maintained. Senior staff involved in recruitment have recently undertaken training in safe recruitment practice. This shows that all reasonable steps are taken to ensure that staff employed are suitable to work with young people.

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Helping children achieve well and enjoy what they do

The provision is good. Observation of staff practice and written records clearly indicate that young people receive personalised support. The home has established links with a range of outside agencies that support young people. Regular liaison with specialist agencies ensures that care staff are kept aware of any issues that might affect young people’s well-being. All staff spoken to are knowledgeable about young people's individual needs. Staff are constantly reviewing the manner in which they relate to young people, in order to ensure they are enabling them to communicate their needs, wishes and concern

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Helping children achieve well and enjoy what they do

Developing educational potential forms a clear part of the home's philosophy of care. Whilst reluctance may be shown by some young people to engage positively with their education, staff are proactive in encouraging and arranging school attendance. Young people accommodated at the home have an education programme devised specifically for them to meet their individual educational needs. Most young people are enthusiastic about the programme that has been devised for them.

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Helping children achieve well and enjoy what they do

As a consequence of a dispute between two local authorities about funding, two young people's files do not contain a Personal Education Plans (PEP). There is detailed documentation 6 of 9 Inspection Report: SC386003 evidencing that the organisation has taken up issues on behalf of these young people with the authorities concerned. Senior managers hope the situation will shortly be resolved. The PEP for the third young person living at the home is being revised by his placing authority as a result of his admission to the home. Care staff support young people's learning through close liaison with teaching staff.

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Helping children make a positive contribution

The provision is good. The home has a number of care planning documents which, when read collectively, provide good information on young people's individual needs and how they will be met. Young people are able to discuss them, confirming they are regularly consulted and their views taken into account.

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Helping children make a positive contribution

Young people are assisted to maintain constructive contact with parents, family and other people significant in their lives. Contact arrangements are discussed at the time of the young people's admission and are recorded in their placement plan. Staff in the home work closely with the young people's families and carers. Young people's views and those of their parents/carers and placing authorities are routinely sought and taken in to account.

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Helping children make a positive contribution

There are suitable procedures in place for young people moving into the home. Young people visit the home before admission, they meet with staff and young people resident and they are given relevant information on how the home operates. Comprehensive transition plans are put in place to support the young people during this period of change. The home does not accept emergency admissions. Young people already living in the home are informed and consulted about new admissions and the organisation takes into account any possible impact new admissions may have on those already resident. Young people admitted to the home will be well known to the organisation as they will previously have been cared for in one of their other registered homes. There have not yet been any young people who have moved on from the home.

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Helping children make a positive contribution

Young people confirm that they are encouraged to be involved in all aspects of planning for their future. They benefit from weekly residents meetings to discuss issues relating to community living. They now chair and record these themselves, inviting staff to join them at the end of the meeting so that issues needing their involvement can be discussed. They all spoke positively about this development. Young people also have fortnightly one to one sessions with their key workers. Young people are clear that they are able to approach any member of staff at any time to discuss issues. Two young people have recently received training which will enable their involvement in staff recruitment. They spoke positively about this opportunity.

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Achieving economic wellbeing

The provision is good. Young people are encouraged and helped to develop independent living skills to help them look after themselves. These include assisting in the planning of menus, shopping and preparation of food. The staff team works with young people on personalised programmes to support the development of their skills. These will link into pathway plans when young people reach this stage of their development. 7 of 9 Inspection Report: SC386003 Documentation shows that when young people show particular skills and interests, the care staff team will find and support them in work placements to develop their skills and self-confidence. The development of young people's self-awareness, self-confidence and life skills in preparation for leaving care is key to the service provided by the home.

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Achieving economic wellbeing

The home is a detached house set in a quiet residential area. It is within easy travelling distance of local amenities and facilities and has front and rear gardens that are suitably maintained. There are good relations with neighbours and young people resident make use of local facilities. The home is well decorated and furnished and kept clean. Young people have a say in the general décor and furnishings, and any repairs or maintenance required are suitably addressed. There is central heating throughout and young people have their own single bedroom which they can personalise with posters and photographs if they wish. Young people's bedrooms have at least one window providing natural light, suitable lighting, furniture for clothes storage and areas for personal study. Young people may have personal electrical equipment in their bedrooms if they wish. A written record is kept of all visitors to the home. There is suitable space for

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Achieving economic wellbeing

young people to engage in leisure activities and meet with visitors in private.

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Organisation

The organisation is good. The home is well managed and efficiently run, providing a safe and stable environment for the young people living there. The Registered Manager is well supported and supervised by senior managers and provides clear management for the care staff team. The care staff team demonstrates an awareness of their roles and responsibilities that ensures young people’s assessed needs are being met.

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Organisation

The promotion of equality and diversity is good. There is a detailed policy and guidance. The quality and detail of care plans ensures personalised services are provided that are capable of meeting young people's personal needs. Ongoing consultation ensures that the young people are fully involved with all aspects of their lives as well as the management and organisation of the home. Matters that promote fairness and understanding of other beliefs and cultures are routinely integrated into staff planning of activities for young people.

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Organisation

The home provides comprehensive details about the care it provides. A user-friendly guide for young people, advises them of what it is like to live in the home. Key workers also follow an induction programme with them to ensure they are fully aware of their rights and also know the expectations of them.

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Organisation

Senior managers and all other staff are committed to providing high quality care for young people and monitor and review staff practice, to improve the service they are providing. Viewing of staff duty rotas and observation of working practices, shows the home is adequately staffed for the young people currently living there. The staff team benefit from strong, energetic leadership and management. The supervision and appraisal of most staff takes place consistently within the recommended timescale, contributing significantly to their own personal development plans. A recently appointed member of staff has not received the formal supervision with the frequency indicated within the national minimum standards. The staff member was able to confirm that informally he received support and supervision during each shift. Staff generally feel well supported and are clear about their own roles and responsibilities.

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Organisation

8 of 9 Inspection Report: SC386003 Regular staff meetings are held to ensure consistency in practice across the staff team. Staff morale is high, resulting in an enthusiastic workforce, which works positively with young people to improve their quality of life.

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Organisation

Staff training programmes include a thorough induction programme. The staff team appear competent in their roles. The home has a National Vocational Qualification training programme in place and are working towards the 80% qualified staff team. These actions show the home has systems in place for staff to obtain relevant training and qualifications.

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Organisation

The organisation has a performance appraisal scheme that ensures all staff have personal development plans in place.

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Organisation

Monthly monitoring visits by the Registered Manager are carried out and form part of the quality assurance system of the home. The organisation also ensures that its appointed representative also undertakes monthly Regulation 33 monitoring visits to the home. The home has developed its quality monitoring systems and seeks feedback from placing authorities, parents or carers and young people at the time of statutory reviews as part of this.

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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

1 June 2010 ensure that the fire risk assessment addresses staff responsibility in relation to the use of door wedges. (Regulation 32)

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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): • consider revising the manner in which safeguarding referrals are documented. This is to ensure there is one record which provides a comprehensive account from referral to outcome of an investigation.(NMS 17) • review all documentation relating to placement planning in an effort to incorporate the majority of information into one working tool which is updated monthly. (NMS 2) 9 of 9 Inspection Report: SC386003

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