Children's Home run by Cumbria County Council in Cumberland

SC034083 Unique reference number 20 May 2010 Inspection date Anne Bannister Inspector Key Type of Inspection

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30 December 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: SC034083

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Brief description of the service

This is one of a number of residential homes, which are owned and managed by the local authority. It is a purpose-built children's home situated within a housing estate on the outskirts of a small town. The home is within easy reach of all local amenities and there is a regular bus service to the town centre. The home accommodates up to six young people of either gender, whose ages range from 12 years old up to 17 years old. Each young person has an individual bedroom. The home works cooperatively with other agencies in order to meet the specific needs of the young people being looked after. The main aim of the home is to enable young people to return to foster placements or family, or to live independently in the community, in accordance with their agreed care plan.

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Summary

This overall judgement is reached following an unannounced full key inspection to the home, which took place over two days. Compliance with the regulations and all the key national minimum standards was assessed. There are six young people resident in the home. The inspector received completed questionnaires from all of them. There was opportunity to speak with five young people during the course of the inspection. The home ensures young people's care, education and health needs are well met. There are suitable systems in place to ensure young people live in a safe environment and are protected from abuse.

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Summary

It has been a very challenging time in the home over recent months. Young people's behaviours are very challenging. There has also been a high incident of staff absence due to illness. The care of the young people remains staff's priority and staff have continued to promote positive outcomes for young people. Documentation is not always evidencing the manner in which this has been achieved. Bullying behaviours are being closely monitored and an action plan is in place to support all involved. Young people have significantly damaged property and a refurbishment plan is in place to repair the damage done. One action and two recommendations are raised in this report. 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

One action and one recommendation were raised following the previous inspection. The action related to the need to notify, without delay, all matters set out in schedule 5 relating to allegations made against staff members and police involvement in the home. Procedures have been reviewed and notifications are now promptly made.

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Improvements since the last inspection

It was recommended that the safeguarding log gave a chronology from start to finish of the investigation. A new recording system has been implemented by the Registered Manager which addresses these issues.

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Helping children to be healthy

The provision is good. The health and well-being of young people is generally well monitored. However not all young people had received routine dental and eye checks. This has been picked up in the organisations 4 of 9 Inspection Report: SC034083 own quality monitoring systems but no action has been put in place to address the deficit. Discussion with staff and young people indicates that menus offer young people access to a balanced, healthy diet. All young people spoken to confirmed they are involved in planning the menu. Some young people had indicated that they felt there is an insufficient budget for food in questionnaires they completed prior to the inspection. There is no evidence to support this. Discussions with both staff and young people confirmed that this issue arose following a period of overspending when both staff and young people needed to be reminded of the weekly food allowance. Young people assist staff in food shopping in order to develop their skills for

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Helping children to be healthy

independence and this includes budgeting their finances. All care staff hold food hygiene certificated training. This ensures they are aware of safe working practices and the procedures to follow when preparing food for young people. Meal times continue to be relaxed social occasions in which appropriate social skills are encouraged.

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Helping children to be healthy

Young people have detailed health plans which are formally reviewed each month. Young people's records are updated by care staff to advise on the outcome of any appointment. Young people's health records indicate that specialist support and advice is sought to meet assessed needs. However, the health plans indicate not all young people are offered appointments for routine dental and eye tests.

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Helping children to be healthy

The home operates procedures that comply with the administration and safekeeping of medicines. These are monitored by the Registered Manager and a designated staff member. Not all medicines are stored in line with specific instructions. Staff advise these are waiting for disposal and are no longer used by young people. All staff have received formal training in the safe storage, disposal and administration of medication. This ensures they are aware of appropriate procedures to follow.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. The staff team are committed to ensuring that young people in their care are protected from harm. The home has suitable policies on privacy and confidentiality. Staff show a respect for young people's privacy and seek to maintain appropriate levels of confidentiality. Good levels of privacy are afforded to young people. Their bedrooms are respected by staff as providing private space. Under normal circumstances, staff do not enter without knocking and receiving the permission of young people. Confidential information relating to young people is stored securely in the staff office.

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Protecting children from harm or neglect and helping them stay safe

Staff inform young people how they can make a complaint if they are dissatisfied with the standard of care they are receiving. Young people know that the young person's handbook also contains information that they can refer to. Two complaints have been made since the previous inspection. One related to inappropriate behaviour being observed by a neighbour. The other resulted in a safeguarding referral being made. Young people feel they can resolve most issues through direct negotiation with staff.

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Protecting children from harm or neglect and helping them stay safe

Members of staff receive appropriate levels of training in safeguarding and behavioural management. Training is regularly updated. Young people are supported by a staff team that has a clear understanding of the complex and diverse needs of each individual. Members of staff are fully aware of the comprehensive policies, guidance and reporting procedures in regard to safeguarding issues. Since the previous inspection the staff team have reviewed safeguarding procedures and a new format for maintaining a chronological record of any incident has been 5 of 9 Inspection Report: SC034083 put in place. There is one ongoing safeguarding referral which has been made since the previous inspection.

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Protecting children from harm or neglect and helping them stay safe

Bullying is a significant problem in the home, with 41 incidents being logged since the previous inspection. A significant number of incidents relate to young people endeavouring to verbally intimidate staff. Action plans are in place to address the issues and young people are aware that bullying in any form is not tolerated. The support of external agencies is being sought to address this problem, which is being carefully monitored by the Registered Manager.

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Protecting children from harm or neglect and helping them stay safe

All physical interventions and sanctions that have been imposed in response to unacceptable behaviours are recorded and are monitored by the Registered Manager to identify trends in behaviours. All staff are trained in behaviour management techniques and are skilled at diverting the young people's negative behaviours into a more positive activity. The Registered Manager oversees the effectiveness of all sanctions given to young people to ensure that challenging behaviours are being appropriately responded to. Staff are using reparation and reward as a more positive way of promoting socially acceptable behaviours. This is due to sanctions not effectively changing young people's behaviour. Some of the behaviour presented by young people is potentially placing them at risk. There are inadequate risk assessments of these behaviours. There is also insufficient evidence that fieldworkers are aware of, and in agreement

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Protecting children from harm or neglect and helping them stay safe

with, the manner in which care staff are responding to these issues.

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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

There is thorough selection and vetting of all staff working at the home prior to employment that meets the requirements of Standard 27 of the children's home national minimum standards. All required pre-employment checks are carried out and staff recruitment records are well maintained. These actions show the home takes suitable measures to ensure staff employed are suitable to be working with young people. There have been no new staff recruited since the previous inspection.

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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. Regular liaison with specialist agencies ensures that care staff are 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. This ensures they are enabling young people to communicate their needs, wishes and concerns.

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Helping children achieve well and enjoy what they do

Education plans are arranged to suit the young person’s individual needs and this was confirmed through documentation. Each young person's file contains a copy of their individual education plan. Care staff support young people's learning needs through close liaison with education providers. Positive feedback was received from the head teacher who indicated that the promotion of the importance of education by care staff is outstanding. Their practice ensures young people's individual educational needs are met. The way care staff achieve this is well 6 of 9 Inspection Report: SC034083 documented in the young people's individual education plans. Young people's files do not contain copies of their personal education plans (PEP). There is evidence that the education co-ordinator continues to request copies of PEPs but that other agencies are failing in their responsibility to provide them.

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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. Plans cover all areas required and they are regularly reviewed. Young people's views and those of significant others are sought when forming and reviewing care plans.

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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 residential action plan. Staff work closely with the young people's families and carers. Young people's views and those of their parents/carers and placing social workers are routinely sought and taken in to account. This practice ensures that young people's relationships with key people in their lives is maintained whilst they are living away from home.

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Helping children make a positive contribution

Young people benefit from weekly residents meetings to discuss issues relating to community living. They also have one to one sessions with their link workers. Young people are clear that there is always someone on duty they are able to approach to discuss issues. Young people benefit from the support of an independent advocate who visits them monthly. Young people's views are passed on to the home by the advocate and are responded to by staff. This ensures young people have access to someone independent of the home to discuss issues relating to their care.

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Helping children make a positive contribution

Staff encourage young people to be involved in all aspects of planning for their future. Young people confirm this. Weekly residents' meetings give young people opportunities to discuss issues relating to community living. Young people also benefit from fortnightly one to one sessions with their link workers. This practice ensures young people are encouraged and supported to make decisions about their lives and to influence the way the home is run.

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Achieving economic wellbeing

The provision is satisfactory. The staff team are skilled at supporting young people to develop their social skills, self-esteem and self-confidence. Care staff assist young people to develop their skills to live independently. Programmes of independence are developed and link in with local authority pathway planning. This ensures that young people receive the support that will prepare them for leaving the home. The staff team are committed to continuing to support young people when they leave the home and many young people continue to benefit from continued contact with the home.

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Achieving economic wellbeing

The fabric and furnishing of communal areas is of a poor standard. A considerable amount of damage has been caused by young people over the past few months. The lounge and bathrooms in particular are in a poor state of repair. New furnishings are on order for the lounge and young people are being encouraged to participate in choosing the decoration. An artist has been employed to assist them in making wall paintings to hang in the refurbished lounge. The purpose 7 of 9 Inspection Report: SC034083 of these actions is to try to encourage young people to take a pride in their home. The local authority and the care staff team are in the process of addressing with young people the issues which lead to the damage. A programme of refurbishment is being implemented. Therefore actions have not been raised as a consequence of this inspection.

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Organisation

The organisation is good. The staff team experiences consistently strong leadership from the Registered Manager and the assistant unit managers. Appropriate arrangements are in place to cover the shortfalls caused as a result of sickness and holidays. These mostly involve permanent staff working additional hours and the use of regular relief staff. This maintains consistency of care for young people. Staff are well supported by each other and generally receive regular professional supervision with a senior member of staff. However, in the first three months of this year this has not been achieved to the frequency specified in the national minimum standards. During this period of high staff absence informal support and supervision, from one assistant unit manager, ensured that all staff felt supported. It enables them to maintain consistency in their practice in dealing with young people's challenging behaviours. As staffing has improved,

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Organisation

supervision is now occurring within the required timescales.

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Organisation

There is a training strategy in place and staff commence National Vocational Qualification at level 3 in Caring for Children and Young People once they complete their induction training. The current ratio of staff having achieved this qualification exceeds the 80% target stated in the national minimum standards. The staff team has a good gender and age balance and young people recognise the different qualities that the team offers. Duty rosters show that despite high sickness rates over recent months consistency of staffing has been achieved.

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Organisation

Monthly monitoring visits by the responsible individual and the Registered Manager are carried out, and form part of the quality assurance system of the home. They ensure that the care of young people is monitored and continually adapted in the light of information about how it is operating.

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Organisation

The progress of young people is closely monitored and recorded within individual files. The contents of files contain all the personal information required by regulations.

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Organisation

The promotion of equality and diversity is good. There is effective care practice that promotes social inclusion and participation. Individual needs are met well especially with regard to age, gender and ability. Young people are involved in a variety of cultural events throughout the year to help improve their understanding of the world around them. Care records are well kept and reflect young people's needs, progress and individuality.

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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

8 of 9 Inspection Report: SC034083 5 July 2010 ensure each child has access to medical and dental as required. In particular this relates to the need for all children to have access to routine dental and eye tests. (Regulation 20.2(a))

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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 a record is maintained of why prescribed medicines are not administered, when medication ceases and when they are disposed of. In particular this relates to the disposal of medicines, with specific storage requirements (NMS 13.2) • ensure that risk assessments are in place for all behaviours which have become a practice within the home. Ensure there is evidence that these are shared and agreed by social workers. (NMS 26.2) 9 of 9 Inspection Report: SC034083

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