Children's Home run by Esland South Limited in Kent

SC059037 Unique reference number 20 July 2010 Inspection date Lucy Ansell 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 8 Inspection Report: SC059037

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Brief description of the service

This is a registered children's home offering 24-hour care and support to young people of either sex aged between 13 and 17 years of age. Referrals are considered for young people experiencing severe emotional and behavioural difficulties, who have a record of offending behaviour, drug and alcohol problems, mild forms of disability and those requiring assessment for specialist placements.

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Brief description of the service

A maximum of four young people can be accommodated at any one time and the home seeks to provide medium to long-term placements. Whilst the home advocates the positive aspects of planned placements, emergency referrals are also considered when appropriate.

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Brief description of the service

The home is a four bed, semi-detached property situated within walking distance of the town centre and local amenities, including shops, a cinema, GP surgery, schools and colleges which are all within easy reach.

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Summary

This unannounced full inspection looked at all of the key standards. The individual health needs of the young people are not being captured and staff need to ensure they are completing medication records comprehensively. Staff's priority is ensuring the young people are kept safe; however the recording and staff's management of young peoples behaviour is an area for improvement. Many opportunities are on offer for the young people however the lack of engagement from some means they do not fully benefit. Care plans and paperwork completed needs regular review and to become more individualised, comprehensive and include the opinions of the young people.

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Summary

Whilst there is good training available for the staff and good policies and procedures have been implemented, the ongoing lack of management and clear leadership has had a detrimental effect with staff lacking skills to provide effective care. The new manager has been in post for one week and is aware of the improvements required to ensure that better outcomes are achieved. 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

The home has made significant progress towards meeting all the recommendations made at the last inspection. The first was to ensure staff supervision was carried out at the frequency stated in the national minimum standards (NMS). The new manager has developed a schedule of proposed supervisions which will meet the NMS.

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Improvements since the last inspection

The second was to ensure that prompt action is taken to rectify shortfalls that are identified in regulation 33 visits. The new regulation 33 report now has a summary which shows previous actions and recommendations and states if they were met.

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Improvements since the last inspection

The third was to ensure that comprehensive dates are given on the employment history provided for new staff applications. The organisations head office ensures full dates of employment are provided for all new staff. 4 of 8 Inspection Report: SC059037

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Helping children to be healthy

The provision is satisfactory. Young people’s placement plans sets out the arrangements for their generic health care. The home's health plans contain insufficient individual information. Young people’s health plans contain information of all services they were accessing and signed parental agreement to emergency treatment. However there was no evidence of appointments due such as those relating to looked after children medicals, dentist and optician appointments and no reviews on the health plans had been completed.

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Helping children to be healthy

The home's policies and procedures for administering medication are comprehensive. However staff are not completing the medication administration sheets correctly for prescribed and controlled drugs and half of the staff have not received the appropriate training to administer medicines. All staff have first aid training.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Young people's information is confidentially handled. Each young person has their own bedroom to which they have a key.

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Protecting children from harm or neglect and helping them stay safe

The young people said that they knew how to complain if they needed to, and that staff would usually deal with their complaints quickly. The complaints log contained five entries since the last inspection. These were adequately recorded, with staff logging the complaint, the initial action, further action and the outcome.

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Protecting children from harm or neglect and helping them stay safe

There are systems in place to promote the safety and welfare of the young people. The staff have all received child protection training and local authority training is also being accessed this year. The new manager discussed safeguarding at the team meeting to ensure all staff were aware of their roles and responsibilities.

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Protecting children from harm or neglect and helping them stay safe

Staff are clear that bullying is unacceptable and that prompt steps will be taken to address it should it occur. Records showed that there had been a number of incidents, which staff had dealt with appropriately. Young people absent without authority are protected in accordance with written guidance.

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Protecting children from harm or neglect and helping them stay safe

Recording of restraints and incidents is inconsistent. Records lack clarity with a wide variety of descriptions used to record events in the home. The staff team are ineffective in managing young people's behaviours and in recording these. The sanctions log is being satisfactorily maintained. Training in positive handling techniques for staff is up to date.

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Protecting children from harm or neglect and helping them stay safe

The young people live in a home which provides physical safety and security. Fire safety checks are up to date, as are checks of portable electrical equipment. Regular fire drills are carried out and risk assessments are in place.

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Protecting children from harm or neglect and helping them stay safe

The staff personnel files contained all the required information and evidence a careful vetting and robust selection process being undertaken.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. 5 of 8 Inspection Report: SC059037 Staff provide individual personal support to the young people. Although the key worker meetings are not always occurring on a regular formal basis, there are many opportunities for guidance and advice informally. The young people say that they receive staff support and there is always someone they can talk to. The home has links to external therapy services; but there are unacceptable waiting times, and young people are not always receiving services that could contribute to their emotional well-being.

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Helping children achieve well and enjoy what they do

All the young people are accessing education. They are either home tutored or attend the company’s school, or are registered at an off-site school. The home has re-introduced all the young people back into education some more successfully than others. Staff continue to be proactive in their support and acknowledgment of achievements. There is excellent ongoing communication with the home's tutor and school but less frequent contact with the off-site schools. Young people’s files do not contain the required educational records.

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Helping children achieve well and enjoy what they do

The young people have access to a wide range of activities that are suitable for them, chosen by them and stimulate their interest in sports and leisure pursuits. The young people also have access to the company’s caravan and boat.

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Helping children make a positive contribution

The provision is satisfactory. Young people's needs are not comprehensively assessed. Care plans include vague details of how individual needs are to be met; care plans and behaviour management plans are not fully up to date. Young people are not encouraged to be involved in the development of their plan. Formal reviews are undertaken and young people are enabled to contribute to and attend reviews, there is less evidence of recent reviews of the home's paperwork. Support is provided by the key worker prior to and following a young person's review. Staff provide monthly reports to the allocated social worker.

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Helping children make a positive contribution

Young people are enabled to maintain constructive contact with families and friends. Agreements in place are detailed in young people's files. Staff support young people on home visits and where contact is restricted. The young people are encouraged to make friends from the local community outside of the home. The recording of contact visits and contact from other professionals is varied in style and content, and lack any comprehensive recording.

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Helping children make a positive contribution

Young people said that staff listen to them and that they feel their opinions count. Staff take responsibility for ensuring young people are able to have their say and advocate on their behalf where necessary. Key worker sessions are not held on a regular basis.

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Achieving economic wellbeing

The provision is good. All the young people are supported to open a bank account and staff are mindful to encourage saving. The pocket money and clothing allowance sheet is not being properly recorded and signed for by staff.

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Achieving economic wellbeing

The home is maintained to a good standard and provides comfortable accommodation. All the young people are encouraged to personalise their bedrooms. There is an adequate number of bathrooms and toilets for the young people. There is little space for privacy or for formal 6 of 8 Inspection Report: SC059037 meetings. There is a rear garden that the young people can access for play. There is no parking available near the house.

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Organisation

The organisation is satisfactory. Young people are guided through what they can expect from the home through the information in the Statement of Purpose and the children's guide. The promotion of equality and diversity is satisfactory. The home promotes equality and is able to challenge issues of discrimination, racism and inequality. The home promotes uniqueness and the value of respect and positive self image.

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Organisation

The home has lacked clear leadership due to the absence of a consistent manager over the last two years with up to four changes. Staff have lacked clear direction; this is shown in the inconsistency of the records and the effectiveness of the management of the young people. The new manager was clearly able to demonstrate the long term plan for the home and will be supported by the two area managers. The improvement in company wide paperwork and policies and procedures shows what the home's direction of travel could be with clear leadership.

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Organisation

There are clear arrangements for staff to deputise in the absence of the manager through the deputy manager who covers shifts at the weekends. There is also on-call management cover available for evenings and weekends. New staff are supported and receive regular supervision, albeit not fortnightly as stated in the national minimum standards. The new manager is working on this to ensure this is promptly addressed and all staff receive the required levels of supervision.

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Organisation

Staff are not adequate in number to meet the needs of the young people. There are two staff on duty to four young people, this is limiting for staff and young people to undertake activities and complete required tasks. All staff are expecting to complete the provider's core training courses, including training in safeguarding, restraint, first aid and health and safety. The standard of training for all staff is very comprehensive. Most staff hold the required National Vocational Qualification at level 3.

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Organisation

The care of the young people accommodated is monitored monthly through the regulation 33 visitor. Reports of these visits are being sent to Ofsted. They are comprehensive and list areas of concern and for improvement, however the following month's reports do not follow up the previous recommendations. The home is not completing any regular monitoring or quality assurance testing on the service.

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Organisation

Whilst the young people's needs, development and progress are recorded, there does not appear to be any clear evaluative monitoring tools in place for recording outcomes and quality of care for the young people.

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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. 7 of 8 Inspection Report: SC059037

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Due date Action Standard

30 November 2010 keep an accurate record of all medication, prescribed and non-prescribed and ensure all staff are appropriately trained to administer medication (Regulation 21) 30 November 2010 maintain an accurate and up to date record of measures of control restraint or discipline used (Regulation 17) 30 November 2010 establish and maintain a system for improving the quality of care provided in the home (Regulation 34) 30 November 2010 ensure that there is an up to date placement plan for each child or young person accommodated at the home (Regulation 12) 30 November 2010 undertake regular reviews of each child's placement plan (Regulation 12) 28 January 2011 ensure the number of staff looking after the children is sufficient to meet the children's needs, the number of children, or other circumstances require this in order to safeguard and promote the welfare of each individual child. (Regulation 25)

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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 each young person has a clear comprehensive written health plan (NMS 12.2) • ensure all staff are properly managed, supported and understand to whom they are accountable (NMS 28.1) • obtain a copy of the personal education plan for each child (NMS 14) • ensure key working sessions are happening regularly (NMS 15.6) • ensure the pocket money and clothing allowance sheet are being completed and signed for in accordance with company procedures (NMS 11.8) • consider the design, layout and use of accommodation are such that children's individual care and privacy are not compromised (NMS 23.7) • ensure all contact arrangements are detailed in the placement plan and there are comprehensive contact records (NMS 4.2) • consider the benefits of external therapy for young people who have clearly identified

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Recommendations

issues and are on long waiting lists. (NMS 7.1) 8 of 8 Inspection Report: SC059037

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