Children's Home run by Nottingham City Council in Nottingham

SC034969 Unique reference number 3 August 2010 Inspection date Rosemary Chapman Inspector Key Type of 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: SC034969

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Brief description of the service

The home, which is provided by a local authority, is registered to care for five boys and girls aged between 10 and 17 years with emotional and behavioural difficulties, and has one emergency bed. It aims to provide settled care as an alternative for young people who cannot remain within their family, and a safe and caring environment for vulnerable young people who may display challenging behaviours.

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Brief description of the service

The home is situated north of the city centre in a residential area. Local facilities include schools, shops and a medical centre. The building comprises three houses converted into one. Bedrooms are single with adjacent bathrooms and toilet facilities. There are two office areas, lounge, dining area, family room and kitchen.

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Brief description of the service

Five young people were living at the home at the time of this inspection. Young people contributed their views in person and four completed written surveys.

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Summary

This was an unannounced key inspection which considered all the key standards under the five outcome areas of the Every Child Matters framework, and those connected with organisation. Progress in meeting the action and recommendations made at the previous inspection was also evaluated.

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Summary

The home provides a satisfactory service with some good outcomes, particularly in relation to staying safe, enjoying and achieving, making a positive contribution and organisation. Young people's good health is promoted through regular access to a variety of support services which meet their varied needs. Young people are safe, well supported and encouraged to pursue their own interests, both educationally and in their leisure time. Regular contact with the looked after children's nurse and the local police officer is a particular strength of the home, as they provide a great deal of relevant advice and support for staff and young people. The staff team is experienced, well trained and supported which enables them to provide a good quality of care.

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Summary

The majority of the shortfalls relate to various aspects of recording and do not have a significant impact on the care and support young people receive. However, the shortfalls, in particular with regard to medication, have impacted on the overall judgement, which remains as satisfactory. The overall quality rating is satisfactory. 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 one action was made which related to providing staff with appropriate training in the management of medication. This has been achieved. In addition, three recommendations to improve practice were made; these related to fire drills being held at night, the recording of sanctions and young people signing their care plans. One fire drill has been held at night since the last inspection, sanctions are recorded appropriately, but there was no evidence that young people are encouraged to sign their care plans. This recommendation has therefore been repeated. 4 of 10 Inspection Report: SC034969

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Helping children to be healthy

The provision is satisfactory. The home promotes the health of young people to a satisfactory standard. Young people have a varied diet and are encouraged to try different foods and eat healthily. Fresh fruit is readily available in the dining room, along with water and fruit juice, and less healthy snacks are limited. The home currently employs a full-time cook who plans the menus on a five-week cycle. However, she is keen to elicit and respond to the views of young people and receives feedback from young people's meetings and the comments book. She also ensures she asks about likes, dislikes and particular needs when a young person is admitted to the home, so she can provide them with meals that they want to eat. In the past, she has provided halal food and can cater for any special dietary need. Current arrangements are somewhat institutional as the kitchen is often locked; however, young people can and do prepare their own snacks and meals if they

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Helping children to be healthy

want to, as part of the planning for independence. The planned menu is recorded but some of the meals actually served are not. For example, the menu refers to 'children's choice', but what that choice has been is not documented anywhere. Thus staff are not able to monitor young people's food intake to ensure they are eating a suitable and varied diet. Young people eat in the dining room, which is due to be redecorated shortly. Young people were instrumental in asking for this to be done and have been involved in choosing the décor.

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Helping children to be healthy

Young people's health and well-being are promoted through good arrangements to meet their assessed health care needs. Young people's health needs are assessed and documented in a health plan and appropriate services are accessed to meet those needs, such as local doctors, dentists and opticians. The looked after children's nurse visits weekly and is involved in providing advice and guidance to staff and young people, particularly in relation to health promotion issues. There are also very good arrangements with the child and adolescent mental health service, and a voluntary agency which deals with drug-related issues; they provide regular consultation for staff and are involved in monitoring those aspects of the care plan, through multidisciplinary meetings, to ensure appropriate services are in place. Staff practice is supported by appropriate written policies and procedures.

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Helping children to be healthy

Staff are trained in first aid to ensure they can respond quickly and appropriately to minor accidents, and the first aid boxes are regularly audited to ensure the content is appropriate. Staff have received training in medication to promote safe practice. Medication is appropriately stored, there are clear procedures for its administration and a written protocol in relation to homely remedies has been devised by appropriate medical personnel. However, there were some gaps in the recording of medication, the countdown of one set of tablets was incorrect and one health care plan had no record of whether a particular appointment had been kept. These shortfalls could compromise a young person's well-being.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people have their privacy respected, as far as is consistent with good parenting. Bedrooms are single and lockable by the young person, as are bathrooms and toilets. Clearly written procedures guide staff practice so they are aware of their boundaries and limits of confidentiality. Young people are made aware of the circumstances in which their room may be searched. 5 of 10 Inspection Report: SC034969 The complaints procedure is on display as well as detailed in the welcome pack, so young people are clear about how they can raise any issues of concern. Young people commented: 'I would tell my key worker if I was worried about anything.' Complaints are logged, responded to and young people told of the outcome. Recent complaints have been resolved to the satisfaction of the young people which shows their views are listened to and they are taken seriously.

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Protecting children from harm or neglect and helping them stay safe

Policies, procedures and staff practice protect young people from abuse. Staff have training so they know how to respond appropriately to any allegations, and they have ready access to procedures to guide them. The local authority designated officer attended a recent staff meeting to discuss her role and make the staff team fully aware of their responsibilities and how they link with her position. If there are any issues of concern, strategy meetings are called to facilitate a multidisciplinary approach to addressing such matters.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected from bullying. There is a strong anti-bullying stance which staff take, they are guided by written procedures and young people have an anti-bullying care plan which addresses either their propensity to bully or their vulnerability. Strong action is taken to address any incidents. Young people confirmed that staff deal with any incidents, do risk assessments and keep them safe.

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Protecting children from harm or neglect and helping them stay safe

Young people who are absent without authority are protected; staff are guided by clear written procedures, there are excellent links with the local police, an effective working protocol and a proactive approach to child protection. Staff will take car registrations if they are concerned, visit places where young people may be, keep in contact with them by phone to ensure they are safe and well and try to encourage them back home. A police officer commented: 'I have excellent communication and information sharing. The unit has always been fully cooperative and supportive.'

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Protecting children from harm or neglect and helping them stay safe

Young people are encouraged to develop socially acceptable behaviour through positive reinforcement. Poor behaviour is responded to with appropriate sanctions, which are recorded and monitored by the manager to ensure they are appropriate and effective. A survey from a professional noted: 'All offensive language and inappropriate behaviour are challenged immediately. Young people are taught to respect themselves and others.' Physical intervention is rarely used; there has been one instance since the last inspection. Staff are trained in approved techniques to ensure the safety of the young person.

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Protecting children from harm or neglect and helping them stay safe

Appropriate measures are taken by staff to ensure that young people are protected from environmental hazards and live in a safe, secure home. Risk assessments identify and minimise any hazards, fire equipment is tested regularly, drills take place to ensure staff and young people know what to do in the event of a fire and portable appliances are regularly checked. However, the electrical installation check is overdue by two months. The manager agreed to pursue this as soon as possible so the impact on young people will be minimal. The certificate of insurance does not state the name and address of the home; this has a minimal impact on the well-being of young people.

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Protecting children from harm or neglect and helping them stay safe

No new staff have been appointed since the last inspection. However, the manager ensures she has basic details for all permanent and agency staff to ensure they are suitable people to work with children. All visitors are asked for proof of identity, sign the visitors' book and are monitored while on the premises to ensure they do not have unsupervised contact with young people. 6 of 10 Inspection Report: SC034969

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive a good level of individual support to meet their assessed needs. A variety of external services are accessed to provide particular support in addition to that provided by staff at the home. Each young person has a key team but all staff are encouraged to respond to young people's requests and concerns, even if they are not the allocated key worker. In addition, each young person has regular contact with their social worker, the manager who conducts monitoring visits, the service manager who is based at the home and access to an independent advocacy service.

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Helping children achieve well and enjoy what they do

Young people are supported to engage in education and work experiences. The home has established good links with the local school and forges links with other schools if young people continue to travel to a different school. Young people have space and access to a computer to help them with their school work, and staff are committed to supporting them by assisting with homework, attending school events and parents' evenings. One young person commented: 'I have all the facilities I need and staff make sure I do my homework if I need help or make sure it is on time.' The majority of the current group of young people are not of compulsory school age and all have suitable places in college.

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Helping children achieve well and enjoy what they do

Young people are encouraged to pursue their particular interests and engage in leisure activities to promote their self-esteem. Young people have been involved in devising a planner of activities for the holiday period which reflects their interests such as camping and swimming. It also encourages them to engage in activities with other young people in the home and promote friendship groups. A professional commented: 'The staff have a brilliant balance of discipline and free time with the young people. The staff and management are caring and creative and have an encouraging approach in everything they do.'

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Helping children make a positive contribution

The provision is good. Young people have their needs assessed and these form the basis of the residential action plan (placement plan). The local authority documentation is also available in the file for more detailed background information. The placement plans are thorough, regularly reviewed, and provide a useful tool to guide staff in how to provide appropriate and consistent care for the young person. However, there was no evidence that young people were aware of the content of their plans as they had not signed them.

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Helping children make a positive contribution

Young people's needs are regularly reviewed to ensure the care and support provided continue to be appropriate and effective. Additional reviews are called if the need arises. There was very clear evidence that young people are involved in their reviews and complete a consultation form prior to the statutory review. Staff at the home play an active part in all reviews and contribute both verbally and in writing, so that full and accurate up-to-date information is considered as part of the decision-making process.

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Helping children make a positive contribution

Contact arrangements are very clearly recorded on young people's files and they are supported to maintain contact, where appropriate, with significant people in their lives so they retain their sense of identity and belonging. Staff facilitate this by providing transport and support where necessary. Staff also respond appropriately where contact has been inappropriate in order to 7 of 10 Inspection Report: SC034969 keep young people safe and ensure their well-being. Young people confirmed they can keep in touch with family and friends and that they can visit them.

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Helping children make a positive contribution

Where possible young people move into the home in a planned way. They are able to visit in advance and meet staff and young people, ask questions and start to know how the home runs and what is expected of them. One young person said: 'The staff are very welcoming.' Likewise, when young people move on, staff manage this in a way that supports the young person, through providing relevant information and assisting with visits, making a successful, stable transition more likely.

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Helping children make a positive contribution

Young people are encouraged to be involved in decision making and state their views. They have regular key worker meetings, weekly young people's meetings, reviews and informal discussions. This enables them to make a positive contribution and feel that their views and opinions are valued. One young person said: 'Through young people's meetings I can suggest things that will be brought up in the next staff meeting and considered.' However, the home does not currently ascertain the views of parents or social workers in a formal way, other than through the statutory review process, which would provide a further basis for any changes or developments in the care and support provided to young people.

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Achieving economic wellbeing

The provision is satisfactory. All the young people are of an age to have a pathway plan to identify the support they need to make the transition into adulthood. These plans are comprehensive and devised in conjunction with other professionals to provide a full assessment of needs and how these needs will be met. Staff at the home are proactive in pursuing appropriate documentation if this is overdue. Young people are able to develop skills for independent living such as shopping for food, preparing meals, doing their laundry and advice in relation to budgeting. They are supported to keep appointments with their Connexions workers. These practices support young people in a successful transition to independence and adulthood.

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Achieving economic wellbeing

Although the home has domestic-style facilities, a lot of the rooms are locked, such as the two downstairs offices, the kitchen, the laundry and staff toilet, which makes it seem rather institutional. It is maintained to a reasonable standard, both inside and out, is clean and furnished appropriately. There is space for young people to meet visitors in private. All young people have a single bedroom and they are involved in choosing how to decorate this. There is a phone for the exclusive use of young people but this is situated in the dining room and is not private. However, other arrangements are made to enable young people to have phone calls in private; this includes the use of the portable office phone and mobile phones. The local authority has plans to re-provision the service in the very near future to provide smaller living units, as it recognises that the current arrangements are not ideal.

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Organisation

The organisation is good. The promotion of equality and diversity is good. Young people are given appropriate support to meet their individual needs, including those in relation to religion, culture, disability and sexuality. Staff demonstrate a strong awareness of equality and diversity issues, have had training to increase their understanding and skills, and seek out appropriate resources to fill any gaps in their knowledge base. The staff team is diverse in terms of gender and ethnicity; 8 of 10 Inspection Report: SC034969 this provides young people with a variety of role models and staff with varying experiences to provide them with support.

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Organisation

The home has a written, up-to-date Statement of Purpose which gives clear information to parents and others about the services the home provides. Young people are given appropriate information in the form of a welcome pack, so they know what to expect and what is expected of them. Staff are mindful of the need to go through the welcome pack with young people to ensure they understand it and have the opportunity to ask any questions.

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Organisation

The home has a very experienced and stable staff team. This ensures that young people receive the care and support they need from competent staff. The management team consists of a manager and two assistant managers, all of whom are appropriately qualified and experienced. Shift leaders are identified on the rota, and are always permanent, experienced staff. This ensures that the running of the home is directed by suitably skilled and experienced personnel. Over 80% of the staff are qualified to National Vocational Qualification at level 3 in Caring for Children and Young people, and in addition, undertake other mandatory training to ensure they keep their knowledge and skills up to date, in order to provide appropriate and effective support to young people. New staff have a comprehensive induction before they start work to ensure they are competent to meet the needs of the young people. The home has recently

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Organisation

developed a very detailed matrix of staff training which clearly identifies the training undertaken, the date it was completed and when updates are due. This ensures that staff keep up to date, remain competent and skilled, and training does not lapse.

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Organisation

The staffing levels at the home are adequate, the rota reflects the planned arrangements, but the staffing policy does not contain the level of detail required to demonstrate its planned arrangements; neither is it set out in the home's Statement of Purpose. Thus how the home defines an adequate number of staff is not specified. The home has a full complement of staff, reliance on agency staff is limited, which therefore ensures continuity of care for young people, by members of staff who are familiar to them.

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Organisation

The manager undertakes regular monitoring of the home's records and performance to ensure staff are providing a good and effective service to young people. However, although it is clear from her monthly reports that she monitors the records, the records are not signed. Monthly visits are also carried out on behalf of the provider, copies of the reports are sent to the regulator as required and made available to the manager. These visits are comprehensive and identify any shortfalls for the manager to deal with, as well as good practice. The provider is currently looking at developing the service to provide smaller homes, and this is detailed in the service plan.

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Organisation

Young people's needs, development and progress are recorded in their individual files so they have a record of their time in the home. Their files are kept securely and young people are made aware that they can read them, should they wish to do so.

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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. 9 of 10 Inspection Report: SC034969

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Due date Action Standard

30 September 2010 make suitable arrangements for the recording, safekeeping, safe administration and disposal of any medicines received into the children's home and ensure that a written record is kept of the administration of any medicine to any child. (Regulation 21 (1) and (2)(c))

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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 there is a record of menus (as served) to demonstrate the provision of a suitable and varied diet (NMS 10.4) • ensure the electrical installations and equipment are checked at least every three years (NMS 26.4) • ensure the certificate of insurance specifies the name and address of the particular home (NMS 26.9) • ensure children know the content of their overall care plans and placement plans and are given the opportunity to sign them (NMS 2.6) • ascertain the opinions and views of the parents of children at the home and the relevant contact officers in the placing authority and take these into account when developing or changing the operation of the home(NMS 8.6 and 8.10) • ensure that the staffing policy is set out in the Statement of Purpose and addresses the areas in standard 30.2 (NMS 30.2)

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Recommendations

• ensure the registered person of the home monitors and signs the home's records at least once a month. (NMS 33.1) 10 of 10 Inspection Report: SC034969

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