Children's Home run by Derbyshire County Council in Derbyshire

SC036262 Unique reference number 20 July 2010 Inspection date Mark Ryder 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: SC036262

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Brief description of the service

This children's home can accommodate up to four young people aged between 11 to 17 years. The home provides medium to long-term care for young people with emotional or behavioural difficulties.

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Brief description of the service

The home is a detached property amongst similar residential properties. The young people have single bedrooms with bathrooms located on the ground and first floor. The lounge, dining area, kitchen, education room and staff office are on the ground floor. There is a garden to the rear of the property including a fully equipped gymnasium. Car parking is at the front of the property. There is easy access to local shops and leisure facilities and there is access to public transport.

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Brief description of the service

Four young people are presently in placement. One young person contributed to the inspection.

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Summary

At this unannounced full inspection, all key standards were assessed. This is a satisfactory service with some good aspects. Young people's health needs are well met. Education is promoted and activities are planned for young people to pursue their interests. The health and safety of all who work, live or visit the home is suitably considered and addressed. Young people benefit from an experienced, competent and motivated staff team who treat them with respect. Care planning, assessment of need and review of the arrangements for being looked after are good. Consultation with young people is an integral part of the culture of this home.

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Summary

However, there are areas for future development. The policy on complaints is out of date and notifications of significant events that should be sent to Ofsted are inconsistent. Staff recruitment files and information about suitable checks do not meet regulations. Formal supervision of staff is not undertaken as frequently as required. Recording of incidents of absconding do not cover all the necessary details to reflect the good practice within this home. Young people's religious and spiritual needs are not clearly recorded or evidenced in care plans. The internal monitoring of the records and practice within this home is not conducted at regular intervals. 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 last inspection two actions and two good practice recommendations were made to improve the safety and quality of care provided. All have been satisfactory met.

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Improvements since the last inspection

Staff and young people are now all aware of what actions to take in the event of a fire. This will ensure a much safer process for all to evacuate the home if such an incident occurs.

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Improvements since the last inspection

Staff have received guidance and have a planned training strategy to support young people who self harm. Staff are competent and aware of how to respond to young people who present this type of behaviour.

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Improvements since the last inspection

The certificate of insurance now includes the full name and address of the home, confirming that suitable public and employee liability cover is relevant to this service. 4 of 10 Inspection Report: SC036262 Room searchers are completed using an agreed protocol that ensures young people are fully informed of the reasons why such a search is necessary. This process is recorded and monitored. Young people understand the process and the necessity for this to occur if staff have concerns.

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Helping children to be healthy

The provision is good. Young people's health needs are met through a balanced diet, regular checks with health professionals and safe administration practice of medication.

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Helping children to be healthy

Staff and young people complete weekly menu planners during resident meetings thus contributing to the meals provided. The menus also include a good variety of culturally diverse foods which young people enjoy. Young people say they have a full choice of the food they like to eat and are able to both shop for and cook meals. The home is supported by a trained cook who provides very well prepared meals throughout the week. Menus are nutritionally balanced with fresh produce from the garden. Fruit is freely available for young people to eat during the day. Food hygiene practice is followed with suitable training for all staff. This has also been offered to young people. The dining area is suitable for young people and staff on duty to sit and eat together. Meals are seen as a social occasion which benefit young people in communicating with staff.

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Helping children to be healthy

Medication is administered safely. Records provide a good overview of when medication is given, the dosage for each young person and the staff involved. Young people are able to self medicate after assessment of potential risks are addressed. Medication is stored in a suitable cabinet, clearly marked and locked. Consent from someone with parental responsibility for staff to provide minor first aid and non prescribed medication for young people is kept on file.

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Helping children to be healthy

Young people attend and are registered with the local General Practitioner, dentist and opticians. Young people are able to choose whether they see a male or female doctor. Health assessments of young people are carried out annually. The home benefits from a specialist nurse who works with young people in residential care. They are able to visit young people and to advise them on a range of health related issues such as sexual health. Trained counsellors in supporting young people who misuse drugs and alcohol provide young people with guidance and information. Child and adolescent mental health services are also available for young people to help and support them on issues affecting their lives. Young people feel that staff provide good care when they are unwell. A young person said that, 'staff look after me when I'm not well.'

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Young people benefit from a suitable environment to live, experienced and competent staff to provide care and robust policies and procedures to ensure they are safe and well.

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Protecting children from harm or neglect and helping them stay safe

Staff respect young people through awareness of their rights to privacy and confidentiality. Room searchers are completed in line with the local authorities protocol and only if there are concerns about the safety and well-being of young people. Young people are informed of such searchers. Sensitive and personal information about young people is kept within the office and placed in lockable cabinets. Staff are mindful not to discuss confidential information in front of young people or visitors to the home. 5 of 10 Inspection Report: SC036262 Young people know how to make a complaint at this home. The process is available in a guide to the service that is written in a format easy for young people to understand. The complaints process is also included in the home's Statement of Purpose for social workers, parents and other outside agencies to use. However, the home's policy is out of date and does not include

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Protecting children from harm or neglect and helping them stay safe

the current regulator or contact details. This could potentially cause confusion as to who to contact if somebody wishes to make a complaint to Ofsted.

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Protecting children from harm or neglect and helping them stay safe

There are procedures to inform Ofsted of any serious event that impact upon the young people and home. However, on a number of occasions this did not occur. Whilst the impact on the welfare of the young person was not compromised on these occasions, the omission prevents regulatory assessment as to how appropriately the service responds to such incidents and the actions taken to reduce risk. This is an area for development.

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Protecting children from harm or neglect and helping them stay safe

Staff are aware of the procedures to follow if a safeguarding incident or concern is identified. There is regular training for staff and guidance on child protection is available within the home. There has not been any recent safeguarding referrals from this service. Young people comment that bullying is not a concern at this time. Staff respond to bullying behaviour and assess each young person's risk to either being a victim of bullying or a perpetrator. Young people have an opportunity to contact outside support agencies if they feel concerned about the behaviour of other residents. Posters referring to anti racism also underline that staff will challenge such behaviour and support young people who are victimised in this way.

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Protecting children from harm or neglect and helping them stay safe

Relationships between staff and young people are good natured, friendly and supportive. Young people are aware that there are boundaries in place and consequences for unacceptable behaviour. The use of sanctions, known as restorative outcomes are proportional to the behaviour that warrant it. A young person said that the rules were fair. Staff receive training on the safe use of physical intervention. The training is nationally recognised and accredited. The level of restraints in this setting is very low.

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Protecting children from harm or neglect and helping them stay safe

Young people who exhibit self harming behaviour are helped by staff to seek medical assistance and to talk about their concerns. Referrals to the child and adolescent mental health services are made although the response time is very slow. Staff continue to discuss self harming behaviour, strategies to reduce the risk to young people and to receive appropriate training. This is an improvement since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Young people who are missing or absent without the consent of staff are reported in line with locally agreed protocol and individual risk assessment. A record of each incident is made although the details of the reasons why young people went missing are inconsistent. This means it is not always clear why young people were missing or absent and what strategies are required. However, for young people who put themselves in significant danger interagency meetings review the level of vulnerability and plan how to reduce the risk.

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Protecting children from harm or neglect and helping them stay safe

Recruitment of staff follows a protocol in line with the local authority to ensure all staff have been suitably vetted and checked. However, staff records do not all include the necessary information to evidence this has been completed. For example, it is unclear whether applications have any gaps in employment history or whether such gaps have been fully explained. For some files it is unclear when the last Criminal Records Bureau check had been completed. This is an area that could be improved upon. 6 of 10 Inspection Report: SC036262 Visitors to the home are asked to sign in and out of the building. Identification is checked and visitors who do not have evidence that they have been vetted are supervised throughout their time at the home.

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Protecting children from harm or neglect and helping them stay safe

The health and safety measures of this home ensure young people; staff and visitors are protected in line with policy and procedures. Regular checks to fire safety, including fire drills, ensures staff and young people are aware of what actions to take. Portable appliance testing and gas maintenance checks are annually completed. Electrical wiring certification is up to date as well as public and employee liability insurance. The name and address is recorded on this document which is an improvement since the last inspection.

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Helping children achieve well and enjoy what they do

The provision is good. Education, planned activities and regular support enable young people to make significant progress throughout their placements. Therapeutic services provide young people with an opportunity to talk about issues affecting them. Whilst not all young people engage with such support, the staff encourage and assist them to make the best use of their time at this home. The team receive consultation from a psychologist about different strategies to help and engage with young people. Staff welcome this process, recognising the benefits of having a greater understanding of a young person's emotional needs whilst in their care.

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Helping children achieve well and enjoy what they do

All young people have an education plan which staff actively promote. There are a number of incentives for young people to engage with education although this does not work for all. Weekly timetables of both education and recreational activities are available. Young people are encouraged to participate in this process. A young person said staff support them to attend school. A survey from a teacher explained that, 'staff do recognise achievements and use positive language to encourage and reward young people. They have a positive image towards personal educational plans and education meetings.'

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Helping children achieve well and enjoy what they do

Staff enable young people to make the most of their placements through providing a range of activities. Young people's interests are encouraged and significant efforts made to ensure the young person is able to pursue the activity of their choice. For example, singing lessons or outdoor pursuits. Young people are pleased with the range of recreational activities available to them.

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Helping children make a positive contribution

The provision is good. Information from care plans assist staff and young people to work together, recognising the reasons for the placement and what is hoped to be achieved during their stay at this home. Young people are able to contribute to their care plans and are aware of what is written about them. Essential information within the plans include details on education, contact with families and health. Young people's cultural identity is recorded although there is limited information on whether young people's religious or spiritual needs are recognised. Whilst it is not apparent that this has any impact on young people presently, for future placements this may be necessary.

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Helping children make a positive contribution

A meeting to review the arrangements for each young person's placement is conducted within timescales. Young people's wishes and feelings are sought and reflected in such meetings. Although not all young people want to attend their review, they are given every opportunity 7 of 10 Inspection Report: SC036262 of doing so. Staff consult with young people to ensure that their views are accurately expressed at this meeting if they are unable to attend.

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Helping children make a positive contribution

Young people have regular contact with their parents. Contact plans are made to clarify the arrangements. These are regularly reviewed in light of young people's views or issues that may affect their well-being. Staff develop positive and friendly relations with parents, understanding the need to work in partnership to help young people through their placements. A number of young people are able to stay overnight at home which they consider a positive experience.

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Helping children make a positive contribution

Young people say that they are listened to and respected by staff. Weekly residents meetings provide a structure for young people to contribute to their experiences at the home. Key working sessions are frequent, enabling young people to talk to staff about a range of issues. For example, behaviour, sexual activity and misusing alcohol. For some young people they are further supported by an independent advocate who is able to listen to their concerns outside of the staff team. Young people also have information available to contact support groups in confidence if they so wish.

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Achieving economic wellbeing

The provision is good. Young people are encouraged to develop independent skills to assist them during their transition into adulthood. For example, young people are able to cook, shop and to take some responsibility over budgeting. Pathway plans reflect the progress, or otherwise, of young people's readiness to move out of the home. Care staff work closely with after care support services to enable young people to understand what is required of them. For young people who do not feel ready to engage in the planning of their future from the home the staff and after care workers use creative ways to encourage them to do so. For example, the use of financial incentives ensure young people attend education or meetings to discuss their future. A young person wrote that staff 'get me to cook, do my own washing and encourage to keep my room tidy.'

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Achieving economic wellbeing

The accommodation is suitable for young people, providing an environment which is well maintained, decorated and furnished to a good standard. Young people are able to personalise their own rooms with posters and photographs. There is ample space for young people to relax and enjoy their free time within the home. For example, young people are encouraged to help with the vegetable garden, visit the well equipped gymnasium or use the home's computer.

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Organisation

The organisation is satisfactory. The management of this service ensures young people are safely cared for by a motivated staff team that is experienced, competent and suitably trained.

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Organisation

The home's Statement of Purpose accurately reflects the function and practice within this home. It includes all necessary information for a reader to understand what the home sets out to do, how it plans to do it and what they hope to achieve for young people. A guide for young people, written in a suitable and easy to read format, provides helpful and necessary information for new residents. A young person said they were given the guide and that it was explained to them when they first arrived. 8 of 10 Inspection Report: SC036262 Staff receive training that enables them to care for the young people in a safe and supportive way. Safeguarding, physical intervention, fire training, first aid and food hygiene are some of the courses staff have undertaken over the last 12-months. All staff who have completed their probationary periods are qualified to at least National Vocational Qualification (NVQ) at Level

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Organisation

3. A significant number of staff are now qualified to NVQ at Level 4.

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Organisation

Staff feel supported by the management of this home. Informal discussion about issues affecting the young people are a regular and daily occurrence. However, supervision between the Registered Manager and staff is inconsistent and does not meet the necessary regulatory requirements. This means that staff, both experienced and new, are not provided with an appropriate level of formal supervision in which a record is made of their professional development, practice issues and any personal concerns that may impact on their work. This is an area for improvement.

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Organisation

Experienced and skilled staff lead and coordinate each shift. New starters work with staff who can offer them guidance and support. Young people benefit from a suitable mix of staff on duty to assist them in their day to day lives. Staff are able to plan when they will be working through rotas completed in advance. Staff do not work excessively long hours.

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Organisation

The promotion of equality and diversity is satisfactory. Staff respond to young people as individuals and have an understanding of the potential stigma associated with being in care. Care planning reflects each young person's personal needs and identifies any cultural or gender issues that may impact on their care. However, there is little or no reflection on a young person's religious or spiritual backgrounds.

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Organisation

Monitoring of the home's records and practice is undertaken by the Registered Manager. Although informal checks are carried out on such records as behaviour management, care plans and daily records, this is not always suitably recorded. Records are not signed by senior staff to ensure standards are being met on a monthly basis. This means that the monitoring system in place does not consistently address how the home is operating in relation to the Statement of Purpose. A senior member of the organisation visits regularly and provides detailed feedback to the manager and staff. Actions required are addressed within suitable timescales. For example, the requirement to improve the condition of the home was acted upon and met promptly.

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Organisation

The home maintains young people's files securely. Young people are able to view their files although this is not regular practice within this home. The plans for young people accurately reflect their progress, or otherwise, of their placements. Social workers are provided with monthly summaries of how the young people in placement are doing. A social worker wrote that, 'I was made to feel welcome. There is good communication between social workers and staff.'

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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

9 of 10 Inspection Report: SC036262 13 August 2010 ensure that the complaints procedures include the name, address and telephone number of the regulatory body (Regulation 24.4) 13 August 2010 notify without delay the relevant persons or agencies of the matters set out in Schedule 5 in particular serious accidents sustained by a child and involvement or suspected involvement of a child accommodated at the home in prostitution (Regulation 30.1) 13 August 2010 obtain for all staff, before they start work at the home, all the information set out in Regulation 26, Schedule 2 (Regulation 26.3) 13 August 2010 ensure that all persons employed receive appropriate supervision. (Regulation 27.4)

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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 written record is made of the circumstances of all incidents of absconding, all action taken by staff, the circumstances of the child's return, any reasons given by the child for absconding and any action taken in the light of those reasons (NMS 19.6) • ensure placement plans include religious and spiritual needs of young people (NMS 2.1) • ensure there is a system in place to monitor the performance of the home against its Statement of Purpose including monitoring and signing the home's records at least once a month. (NMS 33.1) 10 of 10 Inspection Report: SC036262

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