Children's Home run by Laurel Leaf Homes Ltd in Newham

SC060545 Unique reference number 28 April 2010 Inspection date Joanna Heller Inspector Key Type of Inspection

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25 September 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: SC060545

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Brief description of the service

The home is registered to take eight children, aged 10 to 16 years, with learning disabilities or emotional and behavioural difficulties. The property is a large extended corner house. There are eight en-suite bedrooms, including three on the ground floor, a lounge, games room, staff room, office, kitchen, two shower rooms and one bathroom. The home is situated in a central area on the outskirts of a large city close to public transport and many local amenities.

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Summary

This was an unannounced, full inspection carried out as part of the annual inspection programme. The inspection focused on all the key national minimum standards.

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Summary

Young people are positive about staff and say they feel safe at the home. Staff receive training appropriate to the roles they perform. The home, however, fails to: ensure the building is maintained to national minimum standards; ensure young people are safeguarded from fire; manage pest control effectively and ensure that sufficient information is known about young people to enable staff to provide high quality care. The overall quality rating is inadequate. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

At the previous inspection the home was asked to ensure staff working patterns allow staff suitable breaks. The home has changed the staffing rotas to ensure this now occurs. The home was also asked to ensure that health and safety in the home was maintained. This was particularly in relation to portable appliances, which the home has addressed. However, issues relating to fire safety are raised at this inspection and this has been a previous issue of concern. A large number of other issues have been raised at this visit resulting in the home being graded as inadequate.

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Helping children to be healthy

The provision is inadequate. Young people benefit from a variety of nutritious home cooked foods which reflect young people’s choices and cultural heritage. The main shopping is purchased via online. This is supplemented with produce purchased from local shops. Young people are encouraged to cook for themselves and assist in the preparation of meals. Although young people prefer convenience foods, favourite home cooked meals include rice and peas and joliffe rice.

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Helping children to be healthy

All staff have now received training in food hygiene. Staff have not, however, always fully understood the principles of the training and put this into practice. For example, issues of food storage were raised during the inspection. Systems for pest control management in the home are ineffective, an infestation of cockroaches presents a hygiene risk to young people and makes their living conditions unpleasant. The home owner's attempts to address this had been ineffective, leaving cockroaches as an ongoing concern for over a month.

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Helping children to be healthy

The home does not have sufficiently robust systems in place for the storage and administration of medication. For example, young people managing their own medication had no assessments 4 of 10 Inspection Report: SC060545 of suitability to do so. Medications were left on a bed side table in an unlocked room enabling other young people to access them.

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Helping children to be healthy

Staff provide support and care to young people who are feeling unwell and offer to make medical appointments where appropriate. Staff discuss with young people issues of personal care, cannabis usage and smoking. Young people, who have been living at the home for a period of time, have a health plan and have been encouraged to become registered with medical professionals. Young people are encouraged to attend medical check ups; however, some are resistant to this. The majority of the young people living at the home are recent emergency admissions and such appointments have yet to be made. In some cases little medical information is known and arrangements for consent for medical treatment are not documented.

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Protecting children from harm or neglect and helping them stay safe

The provision is inadequate. Four young people were spoken to as part of the inspection. While some had lived at the home only a short time, the consistent message was that all felt safe and well cared for. Feedback regarding staff was positive. Young people made comments such as, they are ‘nice people and are funny’. Similarly the police liaison officer reports that they have had no reason to be concerned about the welfare of young people living at the home. Observation of activities during the day showed genuine attachments have developed between some young people and staff.

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Protecting children from harm or neglect and helping them stay safe

Staff working at the home have undertaken child protection training within the past year. However, newly appointed staff have not. Some newly appointed staff fail to understand the homes policy and procedures and what to do should an allegation be made.

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Protecting children from harm or neglect and helping them stay safe

Basic risk assessments are in place for young people who have been living at the home for sometime. However, these fail to relate to some key areas of risk such as a history of violence. Newly placed young people do not have any risk assessments in place which identify their vulnerability and any risks they may pose to others. These issues place both staff and young people at potential risk.

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Protecting children from harm or neglect and helping them stay safe

Staff adhere to the principles of privacy and confidentiality, for example, staff do not enter rooms without permission and files are stored securely. However, the lack of appropriate screening at the bathroom window overlooking a busy main road, means that either intentionally or inadvertently young people could expose themselves to a member of the public. Young people are supervised when accessing the computer to ensure that no inappropriate usage takes place. A computer game deemed unsuitable for young people under 18 was stored in the computer room.

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Protecting children from harm or neglect and helping them stay safe

Young people say they feel able to raise issues of concern with the manager and are confident that they will be dealt with. However, the issue of cockroaches was cited as an example of where the resolution of a complaint had not been reached.

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Protecting children from harm or neglect and helping them stay safe

Young people who go missing are notified to the appropriate agencies in line with local guidelines. Staff respond to their needs and make them feel welcome when they return but do not always record these discussions following their return. The manager ensures that any significant events are notified to the appropriate authorities. 5 of 10 Inspection Report: SC060545 Young people are aware of the rules in the home, feel that these are fair and that sanctions applied are appropriate. Sanctions records are not maintained clearly. For example, on two occasions the actual sanctions applied were not detailed. No prohibited sanctions are used. Staff discuss young people’s behaviour with them and the consequences. However, there is no effective system in place for promoting good behaviour. Staff report that they feel they have very limited control with low level behaviour management. Staff are trained in dealing with

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Protecting children from harm or neglect and helping them stay safe

complex and challenging situations and when behaviour escalates and presents real challenge, staff are able to deal with this. Restraint has not been applied in the past year. Feedback from the local police liaison officer is that staff are able to manage complex situations and do not rely overly on police to enforce conduct issues.

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Protecting children from harm or neglect and helping them stay safe

The provider has made sure that the building is safe in relation to gas and electrical supplies. However, the provider fails to ensure that fire precautionary arrangements in the home ensure young people and staff are safeguarded from fire in line with current good practice. This is despite having this brought to their attention via the monitoring visits carried out under Regulation 33.

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Protecting children from harm or neglect and helping them stay safe

Young people are not fully safeguarded from unsuitable people gaining employment in the home through robust vetting practices. The manager ensures that checks are carried out on an applicant’s criminal history and identity before employing them. The manager also takes up two written references. However, previous employment with children is not always followed up and discrepancies between application forms and references are not always fully explored. This may result in an unsuitable person gaining employment.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. The staff team is diverse and staff are able to provide positive male and female role models from a variety of cultural backgrounds. Young people who have been living at the home for over a month have a care plan which covers all key areas of need. Young people say they are treated as individuals. Staff are aware that the information they have about some young people is very limited and are discussing things with them to gain more information.

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Helping children achieve well and enjoy what they do

Most young people have a school or college placement which is being successfully maintained. Staff are actively promoting the importance of attending school each day with varied success. Attendance is monitored through automated systems in schools which are followed up with staff contacting the school or college staff. Young people have supervised access to a computer and a selection of books are available.

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Helping children achieve well and enjoy what they do

Young people are able to enjoy the supervised use of a games room which includes snooker and table tennis tables. Young people also enjoyed a holiday last summer. Currently, however, very little organised activities are taking place. The manager is unwilling to give young people money in hand to go on activities, due to drug use, and young people are unwilling to go on supervised activities.

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Helping children make a positive contribution

The provision is inadequate. Only one young person out of eight living at the home was a planned admission. In the past 12 months all placements have been emergency placements and there is little information to 6 of 10 Inspection Report: SC060545 suggest that the home decides any referrals are not appropriate. The home's primary function has, therefore, become by default, one of an emergency admission unit. However, this is not in the home's Statement of Purpose nor is it underpinned in a safe way with good processes for assessment and admission. For example, for three admissions occurring within fourteen days of the inspection, no placement planning meeting had been held and no clear placement plan was in place. Insufficient information at the time of admission for some young people means that there is not always enough information to enable the home to provide good care.

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Helping children make a positive contribution

Some young people are only staying a short time and then being moved on to a more appropriate placement. This limits the ability of the home to effectively support these young people as no clear goals or plans are in place. Where young people remain in the home for some months, statutory reviews take place within prescribed timescales and staff implement effective internal monitoring and reviewing systems. Copies of these monthly reports are made available to placing social workers.

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Helping children make a positive contribution

Young people are consulted formally through the statutory reviewing processes. Young people’s meetings are scheduled regularly, however, young people are declining to attend these. Staff continue to ensure that young people are informally consulted individually on all aspects of their care. Young people say that they talk to staff about issues on a daily basis.

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Helping children make a positive contribution

Contact arrangements are in the main managed by young people according to their wishes. Family members are able to visit them at the home but most young people choose to meet at the family home. Any contact issues identified in the information provided to the home are known to staff. Young people are able to make telephone calls to family and professionals through the use of the hands-free office phone. Young people say that this arrangement works well.

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Achieving economic wellbeing

The provision is inadequate. The provider fails to provide a homely and welcoming environment which young people can be proud of. The building is not well maintained or decorated. For example, fire precautionary arrangements in the home fail to ensure young people and staff are safeguarded from fire in line with current good practice. The house has an infestation of cockroaches in food storage areas and living accommodation, which has not been well managed. Maintenance and decoration of the building are poor. For example, walls in the lounge and hallways have large patches where repairs have been made to holes but these have not been painted. Graffiti has not been removed from walls, radiators and carpets. Furniture provided in some young people’s rooms is broken and is not fit for purpose. Young people raise issues of concern that the television and washing machine are broken and that the home does not have a DVD player.

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Achieving economic wellbeing

Staff support young people gain skills for preparing for independence on a daily basis. All young people are expected to do their own washing and laundry with staff support as appropriate. Pathway plans are in place for young people where appropriate. Where young people do not participate with formal pathway plans, staff continue to encourage self-care skills informally. Young people are encouraged to save money. Young people have suitable clothing and personal items such as toiletries. Staff provide support to young people when shopping for personal items due to drug use issues. This ensures that cash for personal items is not used to purchase drugs. 7 of 10 Inspection Report: SC060545

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Organisation

The organisation is inadequate. The promotion of equality and diversity is satisfactory. Staff have attended training in diversity and are aware of the key issues. The home employs staff from a wide variety of backgrounds who are able to respond to the cultural needs of young people living at the home. The ability to achieve further in this area is impacted on by the lack of information and placement planning for young people.

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Organisation

Staffing levels are adequate to meet the needs of the young people. Staffing is arranged to meet the key activity times in the home and flexibly to meet the needs of young people. Where agency staff are used the manager ensures regular agency staff are booked to maintain continuity.

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Organisation

The manager ensures staff receive training in core areas such as child protection, first aid, and managing challenging behaviour, which, is updated annually. The majority of staff have completed a national vocational qualification at level three or are currently undertaking one. New recruits move through an induction process. However, key areas such as child protection are not sufficiently explored leaving some new staff, who have yet to complete full training, unclear of what to do in the event of an allegation being made.

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Organisation

Staff whom have completed their probationary periods receive regular one-to-one supervision ensuring they feel well supported. New staff who are moving through induction, however, do not receive sufficiently regular supervision.

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Organisation

The home is not well resourced and managed. There is a demonstrable lack of investment in the home and commitment to securing a service which operates in line with regulations and national minimum standards. Quality assurance systems identify shortfalls, including some which place young people at risk, yet the registered person has failed to act upon these.

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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

14 June 2010 ensure adequate precautions against the risk of fire (Regulation 32) 14 June 2010 ensure that any unnecessary risks to the health and safety of children are eliminated, in particular in relation to ensuring that infestations of vermin or cockroaches are effectively eliminated (Regulation 23) 14 June 2010 ensure that each child is provided with suitable bedroom furniture (Regulation 31(8)) 8 of 10 Inspection Report: SC060545 14 June 2010 ensure the building is well maintained and decorated (Regulation 32(2)) 14 June 2010 ensure medication is stored securely (Regulation 21) 13 14 June 2010 ensure an adequate assessment of needs is conducted and a placement plan is in place prior to admission, or if not reasonably practicable as soon as possible thereafter, which identifies on a day to day basis how the child will be cared for (Regulation 12) 14 June 2010 maintain a record of each person working at the home in line

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Due date Action Standard

with Schedule 4 (Regulation 29) 14 June 2010 ensure staff are recruited in line with Schedule 2, in particular explore previous positions where applicants have worked with children and areas where information is contradictory (Regulation 26) 14 June 2010 ensure unnecessary risks to health and safety are identified and eliminated, in particular ensure safe food storage (Regulation 23) 19 July 2010 ensure conditions of appropriate privacy, in particular ensure appropriate screening at bathroom windows (Regulation 31(4)) 14 June 2010 review admission processes and the management of accepting emergency admissions (Regulation 4; Schedule 1) 14 June 2010 ensure unnecessary risks are identified and as far as possible eliminated, in particular ensure effective risk assessments are in place relating to children’s needs and vulnerability (Regulation 23) 14 June 2010 ensure all staff are aware of what to do should a child disclose

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Due date Action Standard

an incident of a child protection nature (Regulation 16) 28 June 2010 ensure reviews of the quality of service under Regulation 34 are sent to Ofsted (Regulation 34) 14 June 2010 conduct a review of the behaviour management in the home, in particular how appropriate behaviour is to be promoted (Regulation 17) 28 June 2010 carry on the home with sufficient care competence and skill, in particular act upon the actions listed in this inspection and in Regulation 33 reports (Regulation 9) 14 June 2010 ensure arrangements for the consent to medical treatment are known (Regulation 12) 14 June 2010 operate the home in accordance with the Statement of Purpose. (Regulation 4) 9 of 10 Inspection Report: SC060545

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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): • evidence young people are given the opportunity, following going missing, to discuss the incident and their feelings (NMS 19) • review the provision of activities within the home (NMS 15) • ensure young people do not have access to age inappropriate games (NMS 15) • evidence new staff have supervision every two weeks. (NMS 28) 10 of 10 Inspection Report: SC060545

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