Children's Home run by Derbyshire County Council in Derbyshire

SC035976 Unique reference number 28 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: SC035976

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Brief description of the service

This children's home is registered to a local authority and is located in an urban area. The home can accommodate up to four boys or girls aged between 10 and 17 years with emotional and behavioural difficulties. The home provides medium to long-term care.

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Brief description of the service

The home is a large detached bungalow set back off a street with other residential properties. The young people have single bedrooms with bathrooms located nearby. There is a large lounge and kitchen with a dining area. A sun lounge provides a computer room for young people. There is a garden and car parking at the front of the property. The home is close to local shops and leisure facilities and there is access to public transport. At the time of this inspection four young people were accommodated. Two young people assisted with this inspection.

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Summary

This was an unannounced full inspection in which all key standards were assessed. This is a service that has a number of areas for development with some satisfactory outcomes. Young people feel listened to and are encouraged to play an active part in the progress of their placement. Staff are competent and experienced in working with young people with complex and challenging needs. Staff support young people in moving on from the home and help in developing independent skills. Education is strongly promoted.

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Summary

Areas of improvement have been identified during this inspection in which eight actions and six recommendations have been made. Complaint records are poorly organised and do not evidence the actions and outcomes arising from the concerns expressed. Potential safeguarding incidents are not appropriately recorded or notified to all of the required parties. This means it is unclear what, if any, actions have been taken to address the concerns. There is a lack of recorded evidence that the policy for young people who are missing is suitably followed. Staff files do not have all the necessary information recorded to evidence that they meet regulations. Young people's bedrooms do not have all the necessary items required. Formal supervision and appraisal of staff is inconsistent. Mandatory training for some staff is out of date. The level of monitoring of the home's records and practice is poorly undertaken. This has significant impact

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Summary

on the overall quality of how the home is presently operating. 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

At the last inspection there were four actions and nine recommendations made to address the shortfalls of the home meeting national minimum standards and regulations. Three of the actions and four of the recommendations have now been addressed.

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Improvements since the last inspection

Care plans now reflect the diverse needs of young people including their ethnic and cultural backgrounds. This means that young people from different backgrounds are able to be cared for by staff who understand their cultural needs and specific values. Further work is required to address issues of religion and spirituality.

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Improvements since the last inspection

Young people are being supported to stop smoking. A specialist nurse and a smoking cessation officer visit and offer guidance and advice. Although the impact of this action is presently 4 of 10 Inspection Report: SC035976 minimal, young people now understand that their health is taken seriously to reduce or stop smoking.

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Improvements since the last inspection

Sanctions given to young people are proportionate and applied fairly. Staff use boundaries to help young people develop socially acceptable behaviour.

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Improvements since the last inspection

The home's risk assessment includes front door security. Visitors are requested to ring the bell and staff suitably monitor the front door.

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Improvements since the last inspection

Procedures for introducing children to the home and discharging them are followed and recorded. Staff are aware of ensuring that young people feel comfortable and supported during these times.

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Helping children to be healthy

The provision is inadequate. Young people enjoy a diverse and nutritious diet that they contribute to and enjoy. Health plans and administration of medication are not presently meeting national minimum standards.

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Helping children to be healthy

Young people say they enjoy the food served and that it is cooked to a high standard. Menus are planned weekly in advance through consultation with young people and the cook. This works well. Fresh produce, grown from the garden, is used in the cooking of meals. Menus reflect cultural diversity with meals prepared from a range of different countries that the young people can try. Staff and young people are able to sit and eat together. This is seen as a social occasion, helping young people to talk about their day during a meal. However, not all staff have current training is the safe handling of food hygiene practice. This is an area for improvement.

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Helping children to be healthy

Young people's health needs are addressed by staff and by the specialist nurse for children in residential care. Annual health assessments are carried out and recorded. Staff ensure all young people are registered with the local General Practitioner and that young people have a choice of whether they are seen by either a male or female doctor. Optical and dental checks are routinely recorded and carried out. All staff receive annual first aid training. The staff, nurse and a smoking cessation officer have been working with the young people to try and reduce smoking. Although still in its early days young people felt that the staff are really trying to help them reduce or stop smoking cigarettes. This is an improvement from the last inspection. Health care plans, however, are not complete with significant health related information about young people missing. For example, the lack of information about a young person's immunisations

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Helping children to be healthy

and vaccinations on file means staff may not be able to refer to such information if an accident occurs.

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Helping children to be healthy

Administration of medication practice is not robust or safe to ensure young people are getting the best possible service from the staff. Recording of the administration process does not presently follow the services own policy or national minimum standards. For example, recordings of how many prescribed drugs are actually stored in this home, when medication is refused and the practice of returning unused medication are not evident in any of the records. Monitoring of this area is not robust. This is an area for improvement.

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Protecting children from harm or neglect and helping them stay safe

The provision is inadequate. 5 of 10 Inspection Report: SC035976 Inconsistent practice and poorly maintained records compromises the effectiveness of ensuring young people are kept safe.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy, although respected by staff, is not always maintained by other young people living within the home. For example, young people are able to access another young person's bedroom without their permission due to a bedroom lock not working. Whilst staff are aware of this it is unclear why the lock remains unrepaired over the last three months.

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Protecting children from harm or neglect and helping them stay safe

Young people know how to make a complaint and information is written in an easy to read format and is available to all residents. However, the complaint logs are inconsistent, poorly recorded and do not evidence suitable outcomes from the issues presented. This is an area of concern.

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Protecting children from harm or neglect and helping them stay safe

Staff are aware of how to respond to safeguarding concerns although it is unclear if appropriate procedures were followed in two identified incidents. Some of the staff have not received safeguarding training for a number of years. This may impact on young people's safety. Young people who are absent without the authority of staff are reported as missing according to their level of vulnerability. Records, however, are not clear as to how this is managed by staff. Recordings are made in a number of places which is difficult to monitor and assess how effective the process is. It is unclear, for example, whether a potential safeguarding incident, whilst a young person was missing, had been appropriately responded to. In another incident, in which the police were called due to the threatening behaviour of a young person, it is not apparent that safeguarding procedures have been followed. There is minimal recorded evidence of

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Protecting children from harm or neglect and helping them stay safe

discussion between young people and staff as to the reasons for being absent and the strategies to reduce the likelihood of such behaviour occurring in the future.

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Protecting children from harm or neglect and helping them stay safe

Young people say that staff treat them well and feel that sanctions are 'generally fair.' Sanction logs record the details of each young person's behaviour and the consequences. These are proportionate and reasonable. Staff do not sanction young people for negative behaviour which has been addressed at school. This is an improvement from the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Young people feel that bullying is not a concern at this home. A young person said 'no one bullies anyone here.' Staff are aware of such behaviour and supervise young people accordingly. Risk assessments record any significant concerns regarding young people being the possible victim or perpetrator of bullying and how to respond to such behaviour. There are posters and information available for young people to contact if they have any concerns about bullying within this home.

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Protecting children from harm or neglect and helping them stay safe

Health and safety of young people, staff and visitors is managed to a satisfactory standard. However, gaps in fire safety checks and a lack of risk assessments for potential harmful products undermine this practice.

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Protecting children from harm or neglect and helping them stay safe

Recruitment records do not reflect a robust approach to the vetting and selection of staff. Files have significant missing information regarding safe recruitment practices. For example, the lack of evidence of Criminal Records Bureau checks, gaps in employment not explained and incomplete information on references obtained, presents as poor practice. For some staff, files are missing and cannot, as yet, be properly checked. This continues to be an area of weakness as identified at the last two inspections. 6 of 10 Inspection Report: SC035976

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Helping children achieve well and enjoy what they do

The provision is satisfactory. Young people's individual needs, educational support and recreational activities are satisfactorily addressed at this home. Children and adolescent mental health services work with young people on a range of issues. Staff encourage young people to attend such appointments. Young people receive further support from keyworker sessions and the many informal discussions between staff. A young person said they can talk to anyone at the home and feels supported. Cultural identity is now recorded within care plans although religion is not referred to.

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Helping children achieve well and enjoy what they do

Educational support is beneficial for young people who respond to the high expectations of staff. All young people attend education or training programmes. Young people are fully involved in the meetings to discuss their personal educational plans. There is sufficient quiet space within the home for private study.

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Helping children achieve well and enjoy what they do

Young people continue to enjoy a varied range of recreational activities at this home. Young people can choose the type of activities they like to do and staff ensure that this is arranged if possible. For example, young people are able to go on outings, holidays or physical activities such as swimming.

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Helping children make a positive contribution

The provision is satisfactory. Young people are fully involved in the planning, decision making and recording of their care plan. Consultation with young people is a regular part of the practice within this home. However, health issues that significantly impact on a young person's placement do not feature in either the care plan or the health care plan. This means that staff and young people are not always clear as to how aspects of their placement will progress. Cultural issues are identified within care plans although spiritual and religious needs are not referred to. Although staff are able to clarify that presently no young people attend church or have any other spiritual needs, by not recognising the possibility that young people in the future may have such needs, undermines this area. This continues to be an area for improvement.

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Helping children make a positive contribution

The review of the arrangements for each placement is undertaken within timescales. Young people are invited to attend and play an active part in the discussions and decision making. A young person said, 'I want to know what's been said about me. It's my life.'

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Helping children make a positive contribution

There is regular support and assistance for all young people to keep in contact with their families. Records confirm this is planned and regularly reviewed. However, it is unclear if the team communicate effectively in clarifying the safety and effectiveness of some home contacts with the placing social worker. For example, although staff are concerned about a particular contact taking place at home, there is no evidence that an emergency review had taken place to discuss and assess the risks identified.

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Helping children make a positive contribution

Moving in and out of the home is conducted in a planned and supportive way. The staff are aware of the needs of young people and take care to present the home as welcoming when they start their placement. Staff are equally aware of the need to record these plans and adapt them in light of any issues identified by the young people, parents, social workers or staff. 7 of 10 Inspection Report: SC035976 Consultation between young people and staff is positive. Young people have well-established relationships with the staff and feel safe and confident in discussing any concerns they have. Key working sessions and residents meetings are the more formal arrangements to record the views and wishes of young people. However, young people are encouraged to express their opinions and views whenever they wish. The young people have access to advocates and children's rights officers including contact numbers for support agencies. This ensures young

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Helping children make a positive contribution

people are able to discuss their placements outside of the home if they wish to.

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Achieving economic wellbeing

The provision is satisfactory. Young people are able to gain the skills and experience of independent living through a supportive and structured plan. Staff engage with young people to prepare for their independence. For example, young people move to independent settings as a trial period with the backup of the staff and after care support. They are able to return to the home if further work is required. Pathway planning is inclusive of the views and wishes of young people. Young people gain from cooking and shopping, for example, to help them build up their confidence before they leave.

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Achieving economic wellbeing

The accommodation meets the needs of the young people. The home is suitably decorated and furnished. Young people are able to decorate their rooms in colours they choose themselves. The gardens are very well looked after by young people and staff. The gardens have a vegetable patch, greenhouse and grassed area in which the young people make the most of.

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Achieving economic wellbeing

Young people's bedrooms do not, however, meet national minimum standards in relation to suitable furnishings. For example, a young person does not have a wardrobe to hang their clothes or a suitable lockable facility to place personal items. There is no record as to the reasons why this is the case. This is an area that needs improving.

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Organisation

The organisation is inadequate. The management and organisation of this home provides staff with support to help young people throughout their placement. However, the lack of a consistent approach to supervision, monitoring and specific training for staff undermines this work.

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Organisation

Young people are aware of how this home operates having received a leaflet written in a suitable format, about the setting. The home's Statement of Purpose reflects the practice within this home. The Statement of Purpose is available for staff, parents and the placing authority to read.

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Organisation

Staff comment positively on the support and guidance they receive from the management team. However, supervisions are not routinely recorded to accurately reflect professional development, progress in working with young people and any personal issues which may impinge upon practice. Staff have not received an annual appraisal for many years. This has been identified at previous inspections as an area for improvement.

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Organisation

Staff receive training on a range of subjects in order to meet the needs of the young people. For example, the appropriate use of physical intervention and first aid training is completed annually. Most of the staff have completed a National Vocational Qualification at Level 3 in 8 of 10 Inspection Report: SC035976 Caring for Children and Young People. However, for some staff a number of mandatory training requirements, such as safeguarding and food hygiene training, have not been completed for a number of years. This means that staff may not be adequately trained to manage a situation in which a young person is at risk of harm.

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Organisation

The promotion of equality and diversity is satisfactory. Young people's needs are met through a staff team sensitive to the potential stigma of living in residential care. Menus reflect a diverse range of prepared meals for young people and staff. Culture and race are identified within care plans. However, the care plans do not include any comment on the possible religious or spiritual needs of young people. This remains an area for improvement.

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Organisation

Young people can access their care plans and are encouraged to do so. Care plans reflect accurately the progress and development of each young person. Young people are able to contribute to their plans.

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Organisation

The findings from this inspection demonstrate that robust monitoring is not conducted to ensure national minimum standards are consistently being met. For example, inaccurate and incomplete records have not been identified and responded to. Whilst it is recognised that there is a supportive and enabling culture within the home, records to support this are poorly maintained. This does not reflect positively on a home that young people and placing social workers think highly of.

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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

1 September 2010 supply a statement containing a summary of any complaints made during the proceeding twelve months and the action that was taken (Regulation 24(7)) 11 August 2010 ensure notification (in accordance with Regulation 30) of the instigation and outcome of any child protection enquiries involving any child accommodated in the home to Ofsted and the child's placing authority (Regulation 16(2)) 11 August 2010 ensure a procedures are followed when any child accommodated in a children's home is absent without permission (Regulation 16(4)) 1 September 2010 obtain for all staff, before they start work at the home, all the information set out in Regulation 26 (Regulation 26(3)) 1 September 2010 ensure that each child is provided with sleeping accommodation which is suitable to his needs including his need for privacy and equipped with furniture and storage facilities (Regulation 31(8)) 9 of 10 Inspection Report: SC035976

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Due date Action Standard

1 September 2010 ensure that all persons employed receive appropriate training, supervision and appraisal (Regulation 27(4)) 1 September 2010 maintain a system for monitoring the matters set out in Schedule 6 at appropriate intervals and improving the quality of care provided in the children's home (Regulation 34(1)) 1 September 2010 suppy to Ofsted a report in respect of any review conducted for the purposes of a development plan and make a copy of the report available on request to children accommodated in the home, their parents and placing authorities. (Regulation 34(2))

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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 child has a written health plan covering any necessary preventative measures, with regard to any specific medical or other health interventions which may be required (NMS 12.2) • ensure a record is kept of when and why prescribed medicines are not administered or are refused, when medication ceases and when medication is disposed of (NMS 13.2) • ensure that the home respect a child's wish for privacy with regards to other young people being able to access a young person's bedroom (NMS 9.2) • ensure positive steps are taken to keep children, staff and visitors safe from risk from fire and other hazards (NMS 26.1) • ensure placement plans include religious and spiritual needs of young people (NMS 2.1) • ensure the registered person contacts placing authorities to request emergency reviews in

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Recommendations

relation to concerns relating to the safety of young people during contact. (NMS 3.3) 10 of 10 Inspection Report: SC035976

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