Children's Home run by Capstone Care Provider Limited in Nottinghamshire

SC392712 Unique reference number 28 July 2010 Inspection date Joanne Vyas Inspector Key Type of Inspection

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19 January 2010 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: SC392712

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Brief description of the service

The home is situated on a main road close to the city centre. It provides care for up to three young people with emotional or behavioural difficulties aged between 15 and 18. Accommodation is arranged on three floors. There are three self-contained flats each containing a bed-sitting room, kitchenette and toilet and washing facilities. Office facilities, a communal sitting room and kitchen are situated on the ground floor. There is an enclosed garden to the rear of the property. The home specifically provides for the needs of young people leaving care by providing support and training in order to help them develop independent living skills. One young person was present during the inspection.

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Summary

The home does not comply with all the required procedures and provision of documentation required by the national minimum standards. Nevertheless, young people say that they are happy and feel well cared for. This home has a qualified and caring staff team who endeavour to provide young people with the skills necessary for a successful transition into adulthood. Staff are pro-active and dedicated to ensuring the young people maintain contact with people who are significant to them such as families. The young people are protected by good staff vetting procedures.

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Summary

However, major shortfalls were found. The home does not fully comply with its Statement of Purpose and there is a serious risk of fire which may not be properly contained. Medication procedures are not satisfactory. Planning documentation for young people is not comprehensive. Records are not fully completed or completed on the wrong form. Consequences for unacceptable behaviour are unclear, inconsistent and sometimes unreasonable. Opportunities are not consistently provided to complete independence work such as shopping. Policies and procedures are not regularly reviewed and may be out of date or irrelevant. 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

No actions or recommendations were made at the last inspection but an action was made about recruitment procedures at a compliance visit made in May 2010. The Registered Manager has now put systems in place to ensure they are compliant with recruitment procedures in order to ensure young people are protected.

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Helping children to be healthy

The provision is satisfactory. Staff know what the young people like and do not like to eat. They also actively encourage young people to try foods from different cultures. Young people enjoy healthy, nutritious meals that meet their dietary needs. They are encouraged to help staff prepare meals but rarely go out shopping for food. Staff do not eat with young people as young people generally take their meals up to their flat. A small breakfast bar is available if they wish to eat downstairs. Meals young people eat are recorded in their daily records but this is not always completed. Staff are trained in the safe handling of food. 4 of 9 Inspection Report: SC392712 Young people said that staff look after them well. Staff ensure young people are provided with a satisfactory provision for health care. All young people are registered with doctors, dentists and opticians and attend routine appointments. They also have access to external healthcare

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Helping children to be healthy

professionals including mental health services. Each young person has a health plan which, although is up-to-date, is brief and does not include all the topics outlined in the national minimum standards.

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Helping children to be healthy

The safe handling of medication is satisfactorily managed in this home. The home has very little medication although some is prescribed. However, medication has not been given as prescribed, for example prescribed medication for hay fever has not been given and not reviewed with a doctor to check that it is no longer required. The medication cupboard contains items other than medication which means the cupboard is opened more often than necessary therefore increasing possible access by young people. Medication such as creams and syrups do not have the date of opening recorded, therefore it is difficult to assess if they have been open for longer than their shelf-life. Staff receive training in the safe handling of medication. The medication cupboard is kept locked and access to the key is limited. All accidents are recorded and first aid is given as appropriate. All staff are trained in first aid and renew their training as appropriate.

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Protecting children from harm or neglect and helping them stay safe

The provision is inadequate. Young people feel safe living in this home. A young person said, 'There are people here that care.' Staff are concerned about keeping young people safe but are not fully competent in their knowledge of the home's safeguarding procedures. However, staff will be receiving training on safeguarding young people in the near future. Staff have a good knowledge of the bullying policy although they feel that bullying does not occur in the home. Young people agreed with this view. Staff are knowledgeable about procedures to follow when young people go missing.

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Protecting children from harm or neglect and helping them stay safe

Concerns raised by young people and others such as neighbours are appropriately and swiftly resolved. An advocate for the young people visits them on a regular basis to ensure their views are communicated effectively. Young people feel they are listened to.

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Protecting children from harm or neglect and helping them stay safe

The privacy of young people is respected by staff. The living arrangements provide space where they can relax and easily find privacy away from others if they wish. Staff ensure the privacy and dignity of the young people, such as by knocking on bedroom doors and waiting for a response before entering. All records are kept confidentially. Young people's issues are not discussed openly.

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Protecting children from harm or neglect and helping them stay safe

Staff view young people positively and young people are relaxed around staff. Staff are given training on managing behaviour, which includes de-escalation techniques as well as physical intervention. Physical intervention is used as a last resort. There is a minimal amount of physical intervention carried out in this home. Sanctions are applied infrequently. However, sanctions are not clear to staff and young people, measures applied are not always relevant to the incident or reasonable. Additionally, the central record does not include everything that is specified within the national minimum standards. Therefore, the management of behaviour is inconsistently applied which could lead to more challenges from the young people.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected by good vetting procedures for staff and monitoring of visitors. Safety checks are completed and staff only commence employment when they have a satisfactory 5 of 9 Inspection Report: SC392712 Criminal Records Bureau disclosure and at least two satisfactory references. All visitors sign into the building and must show identification.

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Protecting children from harm or neglect and helping them stay safe

The home has risk assessments for some aspects of safety of the premises and grounds which includes fire and young people’s behaviour and activities. However, risk assessments are not comprehensive in content as they do not include many aspects of life in the home, outside the home and the environment. The home has a current certificate for the testing of electrical installations which were completed in September 2005 prior to registration. However, this does not comply with the national minimum standards which state that electrical installations should be checked at least every three years. All staff are given fire safety training and fire drills are carried out regularly. However, fire drills, so far this year, have not included any young people including new admissions. There are clear fire risks within the home such as young people smoking in their rooms as well as a variety of electrical equipment such as microwaves and

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Protecting children from harm or neglect and helping them stay safe

washing machines within the flats. Fire doors are not satisfactorily maintained and are propped open, therefore they would not prevent the spread of fire. Although this has been highlighted on a recent regulation 33 monitoring report, the problem has been a long-term issue and has not yet been addressed. Young people are not protected by the home's health and safety procedures.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. Staff are positive in their approach to education and its value for young people. Young people have personal education plans. Staff attend meetings with schools and colleges and parents evenings. Young people are supported in their education.

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Helping children achieve well and enjoy what they do

Individual support is detailed in each young person's placement plan but this isn't comprehensive. Young people are encouraged to value their own culture, language and religion by a diverse staff team. The staff know the young people well and are knowledgeable about their individual needs and the implications this has for their care.

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Helping children make a positive contribution

The provision is satisfactory. The Statement of Purpose clearly sets out the home’s admission policy. Young people are supported during the admission process and when leaving the home. Staff carefully consider group dynamics when admitting a new young person.

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Helping children make a positive contribution

Staff provide a satisfactory standard of care to young people and endeavour to meet their individual needs with the knowledge and understanding they have of them. A satisfactory assessment of need, placement plan and risk assessments are in place for each young person. However, the placement plan does not cover all the areas set out in the national minimum standards and only provides basic information. A record is made throughout the day for each young person documenting their mood, activities, behaviour and other relevant information. However, these individual records contain information about different young people as staff have mistakenly recorded events on the wrong person's record. Monthly summaries of each young person's progress are sent to their social worker. Statutory reviews take place within the required timescale. The key worker for each young person writes a report for the review which

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Helping children make a positive contribution

a young person will read and make comment on. 6 of 9 Inspection Report: SC392712 Staff encourage and support young people in maintaining contact with parents and everyone else who is significant to them. Plans detail the role of contact in promoting cultural identity and experiences.

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Helping children make a positive contribution

Young people are given the opportunity to make choices and decisions within key worker sessions, regular house meetings and informally on a day-to-day basis. Young people recognise that staff are supportive in helping and guiding them towards making positive decisions for themselves. Young people are relaxed in the company of staff and are quick to approach them with any issues they may have.

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Achieving economic wellbeing

The provision is satisfactory. This home is set up to accommodate young people who need support with their independent living skills prior to leaving care. Staff encourage young people to carry out some such tasks independently or with support. However, these are not clearly defined and progress isn't satisfactorily monitored. Young people, although they sign up to 'supported semi-independent living' do not fully participate as they have not reached the stage where they can be more independent of staff. This is currently contrary to the home's Statement of Purpose.

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Achieving economic wellbeing

Young people live in a homely environment that is satisfactorily furnished. There is very little communal space but young people have their own flats. The young people have good facilities within their flats. They like their flats. However, décor is bland and tired looking, carpets are stained and there are some unresolved maintenance issues.

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Organisation

The organisation is inadequate. There is a clear, up-to-date Statement of Purpose which does not fully reflect the practice and functions of the home, for example, the document does not discuss young people who are given a residential placement, only young people who have a semi-independent placement. Staff provide each young person with a guide to the home when they first arrive. This ensures that young people understand the ethos of the home, the rules and the type of activities they can expect to be involved in. However, this also does not reflect fully the practice and functions of the home either as previously described. The commitment to promoting equality and diversity is explicit, however, throughout these documents.

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Organisation

Staff training is supported by the organisation. An annual programme covers mandatory training which all staff are expected to undertake. Most of the staff team have qualified to National Vocational Qualification at level 3 or above in the Care of Children and Young People and the few remaining staff are currently working through the qualification.

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Organisation

Staffing levels are adequate to meet the needs of the young people. A record of staff shifts is maintained on the home's rota and this shows there is a balance of gender wherever this is possible. Staff hand over meetings ensure that each shift is appropriately planned and issues arising from earlier are competently communicated.

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Organisation

The promotion of equality and diversity is satisfactory. Although there are examples in this report that highlight good practice within equality and diversity such as the knowledge and 7 of 9 Inspection Report: SC392712 understanding the staff have of the young people, the actions and recommendations arising throughout this report support the judgement of satisfactory.

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Organisation

A new manager is in post for this home who has a strong commitment to improvement. A senior member of the organisation also visits the home on a monthly basis and reports on the conduct of the home. Policies and procedures for the home have not been reviewed since 2007, prior to the home opening so staff may have guidance which is out of date or irrelevant.

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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 August 2010 ensure any medicine which is prescribed for a child is administered as prescribed (Regulation 21) 8 August 2010 ensure, by means of fire drills and practices at suitable intervals, that the persons working at the home and, so far as practicable, children accommodated there, are aware of the procedure to be followed in case of fire (Regulation 32) 8 July 2010 ensure there are adequate arrangements for detecting, containing and extinguishing fires (Regulation 32) 30 October 2010 ensure that the children's home is at all times conducted in a manner which is consistent with its Statement of Purpose (Regulation 4) 31 October 2010 ensure that all parts of the children's home used by children are kept clean, reasonably decorated and maintained (Regulation 31)

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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 the record of menus as served is fully completed (NMS 10.4) • ensure children are provided with opportunities to shop for their own meals (NMS 10.1) • ensure each child has a clear written health plan which covers all the subjects set out in the national minimum standards (NMS 12.2) • ensure there is a policy that is implemented in practice for storing, disposing and administering medication (NMS 13.10) • ensure any consequences of unacceptable behaviour are clear to staff and children and any measures applied are relevant to the incident, reasonable and carried out as contemporaneously as possible (NMS 22.4) 8 of 9 Inspection Report: SC392712 • ensure the central record for sanctions includes all the elements as set out in the national minimum standards (NMS 22.10)

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Recommendations

• ensure risk assessments are carried out, recorded in writing and regularly reviewed (NMS 26.2) • ensure electrical installations are checked at least every three years (NMS 26.4) • ensure all children are given individualised support in line with their needs and wishes, and children identified as having particular needs receive help, guidance and support when needed or requested (NMS 7.1) • ensure each child has a permanent private and secure record of their history and progress (NMS 35.1) • ensure the placement plan for each child includes all the topics set out in the national minimum standards (NMS 2.1) • ensure staff are provided with written guidance on the home's procedures and practice which is kept up to date (NMS 28.8) 9 of 9 Inspection Report: SC392712

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