Setting

X10029.doc Version 1.40 Page 1 FOSTERING SERVICE

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Lead Inspector Romana Young Announced Inspection 22 - 26 January 2007 10:15 am The Commission for Social Care Inspection aims to:

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• Put the people who use social care first • Improve services and stamp out bad practice • Be an expert voice on social care • Practise what we preach in our own organisation

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Reader Information Document Purpose Inspection Report Author CSCI Audience General Public Further copies from 0870 240 7535 (telephone order line) Copyright This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Internet address www.csci.org.uk

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NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Fostering Services. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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Every Child Matters, outlined the government’s vision for children’s services and formed the basis of the Children Act 2004. It provides a framework for inspection so that children’s services should be judged on their contribution to the outcomes considered essential to wellbeing in childhood and later life. Those outcomes are: • Being healthy • Staying safe • Enjoying and achieving • Making a contribution; and • Achieving economic wellbeing.

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In response, the Commission for Social Care Inspection has re-ordered the national minimum standards for children’s services under the five outcomes, for reporting purposes. A further section has been created under ‘Management’ to cover those issues that will potentially impact on all the outcomes above.

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Copies of Every Child Matters and The Children Act 2004 are available from The Stationery Office as above This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection.

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NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 3

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Name of service

NCH Devon Family Based Short Break Service

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Name of service

Address The Old Vicarage First Floor Offices Vicarage Street Barnstaple Devon EX32 7BT Telephone number 01271 373275

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manager (if applicable)

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Conditions of registration:

Date of last inspection 31/10/05 – 22/11/05

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Brief Description of the Service:

NCH Devon Family Based Short Break Service is an independent fostering service providing a short term and respite foster care service to children and young people with special needs, aged under 18 years, who live in Devon. The service is operated and managed by the registered charity, NCH, under contract to Devon County Council Social Services.

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Brief Description of the Service:

At 31 March 2006, the service had 32 approved fostering households (31 in Devon, and one in Cornwall), providing a short breaks service to 74 children and young people who have a range of special needs, including complex medical needs, and physical, sensory, or learning difficulties. 21 of the fostering households are approved to take one child or young person, at any one time; six are approved to take up to two; and five to take up to three. 44% of the approved fostering households have at least one child of the household, aged under 18 years, living at home. In 50% of the approved fostering households, one or more of the foster carers has achieved NVQ Level 3 in Caring for Children and Young People, or another relevant qualification (for example, NNEB, or qualifications in nursing, teaching, social work or youth work).

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Brief Description of the Service:

The service has an office base close to the town centre of Barnstaple. It employs ten staff, on full or part- time basis, including the project manager, five qualified social workers, a paediatric nurse, two care coordinators, and two administrative support staff.

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Brief Description of the Service:

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SUMMARY

This is an overview of what the inspector found during the inspection.

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SUMMARY

This is the second inspection of this service, which began operating on 1 April 2005.

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SUMMARY

This was an announced proportionate key inspection to assess the fostering service’s operation in line with the Fostering Services National Minimum Standards and Regulations, progress with matters arising from the previous inspection visit and ascertain a baseline quality rating.

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SUMMARY

One inspector undertook this inspection over five days, from 22 to 26 January 2007. During the course of this inspection, the inspector visited the fostering service office base, and interviewed: • The registered manager of the fostering service • Two of the qualified social workers • The paediatric nurse, and • The chairperson of the fostering panel. The inspector, also, observed: • A staff meeting held at the fostering service office • Two meetings of the fostering panel - one on 12/12/06 and another on 25/01/07, which was attended by the Responsible Individual for NCH, and • A foster carer support group meeting in Exeter where she spoke with some of the foster carers who attended. Visits to two foster homes were arranged but, unfortunately, unforeseen circumstances meant they could not go ahead as planned, and it was not possible to rearrange either of them within the time available for the inspection

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SUMMARY

Two foster carers’, two children’s files, and three staff files, were inspected, along with other documentation, which included the Annual Quality Assurance Assessment (AQAA), data sheets, foster carer handbook, schedule of payments to foster carers for 2007 - 2008, the statement of purpose, children’s guide and minutes of three previous fostering panel meetings.

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SUMMARY

The responses in the 18 foster carers, 13 parents, and 5 social workers survey questionnaires returned were analysed and used to inform the judgements made in this inspection report. The young person’s survey questionnaire was not used at this inspection, as it is not a suitable communication tool for the children and young people who use this service.

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SUMMARY

The inspector thanks the fostering service staff, foster carers and parents for their cooperation and assistance with this inspection.

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What the service does well:

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 6 Staff and foster carers continue to show commendable enthusiasm for, and dedication to, providing a high quality short breaks fostering service for children and young people with special needs.

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What the service does well:

There is a sound management structure in place to support the work of the service. Recruitment and induction processes for staff are thorough, and staff are provided with opportunities for continuing professional development. The staff group is experienced and highly competent. Practice in the areas of the assessment, approval, and support of foster carers is of a high standard.

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What the service does well:

Parents feel that the service is excellent at making sure their child is well cared for, and that their child’s individual needs are well met. They feel that the foster carers communicate well with them, and are good at informing them about what is happening with their child when they are away from home. Parents feel the foster carers provide an enjoyable family based experience for their child and, at the same time, are helping them improve and develop their social and independence skills.

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What the service does well:

Care managers feel that the service provides safe, good quality, family based respite care, with suitably trained, enthusiastic carers who have a genuine commitment to caring for children and young people with special needs. They feel that the service communicates well with them, and takes care to find good matches between the child and their family and the foster carer.

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What the service does well:

Foster carers feel they are given excellent training and support by the service. The foster carer support group meeting observed by the inspector was well attended, and highly valued by foster carers. They feel that the service is careful about making good matches between the child and themselves, which ensures good placement stability and a positive respite experience for the child. Foster carers said that the service is good at ensuring that they are provided with all necessary and relevant information about the child’s needs so that they can care for them properly.

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What has improved since the last inspection?

One statutory requirement and one good practice recommendation were made in the previous inspection report and the service has taken action to deal with both of these: • A system has now been out into place to ensure that checks are made with Ofsted, with regard to childminding and children’s day care applications and registration, for new and already approved fostering households. • Children and young people using the service have been consulted about, and assisted with, the redrafting of the service’s children’s guide, so that it contains the information that they feel is relevant and helpful, to them.

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What has improved since the last inspection?

The service is now fully staffed, with an increase in qualified social work support and a full-time paediatric appointed, to give support and training to

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What has improved since the last inspection?

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 7 foster carers caring for children and young people with complex and specific physical health care needs.

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What has improved since the last inspection?

The service is also taking measures to highlight to the local authority cases where it is not fulfilling its statutory duties to children and young people placed with the service, for example with regard to appointing a nominated care manager, conducting care reviews and visiting the child in placement, within the statutory intervals.

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What they could do better:

Parents and care managers feel that there is too long a wait for placements and that the service needs to recruit more carers to deal with this issue. The service is now fully staffed and able to allocate more resources to recruitment. In the period April to October 2006, the service approved five more fostering households, but as another two were deregistered, the overall increase in numbers was only three. The service should continue to make recruitment a priority, so that there is greater choice in matching, and the overall availability of the service can be increased, particularly in some geographical areas where there is poor cover, and for children and young people who have more complex physical needs and limited mobility.

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What they could do better:

The fostering service must ensure that the foster panel is always quorate, when business is being conducted. The first fostering panel meeting the inspector observed did not have sufficient members to allow it to conduct business and an additional panel meeting had to be arranged to allow business scheduled for this meeting to be dealt with. The minutes of a recent previous panel showed that the panel was not quorate on that occasion also (the registered manager of the service cannot act as a member of the panel as she has direct managerial responsibility for the assessing social workers who present reports to the panel). At least five members of the fostering panel (including the chairperson (or vice chairperson), a social worker employed by the service, and two independent members) must be present at any panel meeting to comply with Regulation 25.1 of The Fostering Services Regulations 2002. A requirement has been made.

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What they could do better:

Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request.

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What they could do better:

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CONTENTS

Statutory Requirements Identified During the Inspection

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CONTENTS

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The intended outcome for this Standard is:

• The fostering service promotes the health and development of children.(NMS 12)

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JUDGEMENT – we looked at the outcome for Standard:

Quality in this outcome area is excellent .

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JUDGEMENT – we looked at the outcome for Standard:

This judgement has been made using available evidence including a visit to this service.

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JUDGEMENT – we looked at the outcome for Standard:

The service ensures that essential information about children and young people’s health needs is obtained and shared with the foster carer, and that foster carers are competent, and have the necessary skills, to meet the particular health needs of the children and young people they provide care for.

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EVIDENCE:

Responses in the parent questionnaire survey show that parents are confident that the child’s health needs are provided for when they are with their respite foster carers, and that the foster carers ensure that their child eats a healthy diet, and leads a healthy lifestyle, when they are in their care.

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EVIDENCE:

Inspection of foster carer and children’s files, and discussions with staff, evidenced that foster carers are given specific training with regard to complex physical and health needs of children and young people they are matched with and that their competency to manage specific health care procedures is assessed. The service has appointed a full-time paediatric nurse who is responsible for undertaking a nursing assessment for children and young people with a physical nursing need, producing written guidance for the foster carer, ensuring that they receive any training necessary and are competent to undertake the care that needs to be provided, and undertaking regular reviews.

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EVIDENCE:

Responses in the foster carer survey showed that foster carers feel that they are provided with the information they need about the health needs of children

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EVIDENCE:

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 10 and young people placed with them, and appropriate training and support, so that they are able to provide appropriate and good quality care.

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EVIDENCE:

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The intended outcomes for these Standards are:

• Any persons carrying on or managing the service are suitable. (NMS 3) • The fostering service provides suitable foster carers.(NMS 6) • The service matches children to carers appropriately.(NMS 8) • The fostering service protects each child or young person from abuse and neglect.(NMS 9) • The people who work in or for the fostering service are suitable to work with children and young people.(NMS 15) • Fostering panels are organised efficiently and effectively.(NMS 30)

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JUDGEMENT – we looked at outcomes for the following Standard(s):

Quality in this outcome area is adequate .

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JUDGEMENT – we looked at outcomes for the following Standard(s):

This judgement has been made using available evidence including a visit to this service.

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JUDGEMENT – we looked at outcomes for the following Standard(s):

The service operates very good systems to ensure that children and young people are well matched with foster carers, are being cared for safely, and their welfare safeguarded. Recruitment and induction procedures are thorough. Better organisation of the foster panel is needed to ensure that there are sufficient members in attendance to meet statutory requirements.

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EVIDENCE:

Responses in the social worker questionnaire survey showed that the care managers feels that children and young people are being well cared for, by committed and skilled foster carers, and that the service takes good care with matching children to foster carers.

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EVIDENCE:

Foster carers reported that the service is good at ensuring that they are given the essential information about the needs of the children and young people they look after that they require, in order to care suitably and safely for them, and that the matching and introduction processes are careful and thorough.

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EVIDENCE:

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 12 Checks on foster files showed that written foster carer agreements, placement agreements and safe care plans were in place.

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EVIDENCE:

Discussion with staff confirmed that they had undertaken child protection training.

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EVIDENCE:

While, generally, the fostering panel conducts business in a thorough and professional way, there have been two recent instances when the panel has not been quorate. A requirement has been made. The inspector also noted that the responsible individual was absent from 50% of the meetings in the previous six months. If he is unable to attend, it would be good practice for another senior NCH manager, with knowledge and experience of fostering services, to deputise for him.

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EVIDENCE:

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The intended outcomes for these Standards are:

• The fostering service values diversity.(NMS 7) • The fostering service promotes educational achievement.(NMS 13) • When foster care is provided as a short-term break for a child, the arrangements recognise that the parents remain the main carers for the child.(NMS 31)

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JUDGEMENT – we looked at outcomes for the following standard(s):

Quality in this outcome area is excellent .

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JUDGEMENT – we looked at outcomes for the following standard(s):

This judgement has been made using available evidence including a visit to this service.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Good communication, and working in partnership, with the child’s family are strengths of the service.

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EVIDENCE:

All the parents who responded to the questionnaire survey agreed that the service understands and respects their child’s individual needs, including their culture and ethnicity, and is excellent at addressing their child’s special needs.

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EVIDENCE:

Parents confirmed that the service and the foster carers communicate with them well and respect their parental authority.

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EVIDENCE:

Foster carers confirmed that they receive training on equality and diversity issues and ensuring that cultural, ethnic and other specific needs of children and young people are acknowledged and met.

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EVIDENCE:

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The intended outcomes for these Standards are:

• The fostering service promotes contact arrangements for the child or young person. (NMS 10) • The fostering service promotes consultation.(NMS 11)

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JUDGEMENT – we looked at outcomes for the following standard(s):

This judgement has been made using available evidence including a visit to this service.

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JUDGEMENT – we looked at outcomes for the following standard(s):

Good communication between the service, parents, and the child’s care manager, and good placement planning processes, ensure that individual needs are well identified and met. Some measures to ascertain the children’s and young people’s views about their care are in place, but the service is aware that more needs to be done to ensure that children and young people who use non-verbal methods of communication are assisted to express their views about the service they receive, and it is continuing to look at ways that this can be achieved.

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EVIDENCE:

Parents are satisfied with the way contact is maintained. One parent wrote: • If I wish to talk to my daughter on the phone, it is no problem at all.

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EVIDENCE:

In the parent questionnaire survey, parents confirmed that the service works in partnership with them, and that there is good consultation and information sharing with them and with their child also. Comments by parents included: • I am asked if there is any uncertainty about whether an activity or place would be appropriate or enjoyable for my child. • Reasons for change in the respite family involved my child as well as me. • I receive information about (my child’s) behaviour and the activities he has done. • Lots of consultation by the carers as to what would be best.

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EVIDENCE:

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 15 All but one of the parents who responded to the questionnaire survey said that they knew how to make a complaint if they were unhappy about the care their child is receiving.

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EVIDENCE:

Discussions with staff, and responses in the foster carers questionnaire survey, showed that, where possible, the service tries to involve children and young people in the placement planning and reviewing processes. However, the service does acknowledge that ensuring that there is sufficient and meaningful consultation about the service they receive, with children and young people who use non-verbal methods of communication, is one of the biggest challenges for the service, and they are continuing to explore better ways of ascertaining the views of all the children and young people they provide a service for.

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EVIDENCE:

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The intended outcomes for these Standards are:

• The fostering service prepares young people for adulthood.(NMS 14) • The fostering service pays carers an allowance and agreed expenses as specified.(NMS 29)

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JUDGEMENT – we looked at outcomes for the following standard(s):

This judgement has been made using available evidence including a visit to this service.

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JUDGEMENT – we looked at outcomes for the following standard(s):

There is a system in place for foster carers to be provided with an allowance and agreed expenses to cover the cost of caring for a child or young person placed for respite care. Foster carers are provided with information on current levels of allowances.

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EVIDENCE:

In the parent questionnaire survey, parents said that they feel that the respite arrangement is beneficial to their child, helping them to develop socially, and become more independent. Parents wrote: • Our daughter enjoys her independence time. • Overnight respite helps my son gain independence and confidence. • It allows (my son) to practise and develop social skills and independence.

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EVIDENCE:

Foster carers confirmed that they receive financial assistance to cover the cost of caring for children and young people placed with them.

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EVIDENCE:

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The intended outcomes for these Standards are:

• There is a clear statement of the aims and objectives of the fostering service and the fostering service ensures that they meet those aims and objectives.(NMS 1) • The fostering service is managed by those with the appropriate skills and experience. (NMS 2) • The fostering service is monitored and controlled as specified. (NMS 4) • The fostering service is managed effectively and efficiently.(NMS 5) • Staff are organised and managed effectively.(NMS 16) • The fostering service has an adequate number of sufficiently experienced and qualified staff.(NMS 17) • The fostering service is a fair and competent employer.(NMS 18) • There is a good quality training programme. (NMS 19) • All staff are properly accountable and supported.(NMS 20) • The fostering service has a clear strategy for working with and supporting carers.(NMS 21) • Foster carers are provided with supervision and support.(NMS 22) • Foster carers are appropriately trained.(NMS 23)

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The intended outcomes for these Standards are:

• Case records for children are comprehensive.(NMS 24) • The administrative records are maintained as required.(NMS 25) • The premises used as offices by the fostering service are suitable for the purpose.(NMS 26) • The fostering service is financially viable. (NMS 27) • The fostering service has robust financial processes. (NMS 28) • Local Authority fostering services recognise the contribution made by family and friends as carers.(NMS 32)

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JUDGEMENT – we looked at outcomes for the following standard(s):

1, 2, 16, 17, 20, 21, 22, 23, 24, 25 and 26

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JUDGEMENT – we looked at outcomes for the following standard(s):

This judgement has been made using available evidence including a visit to this service.

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JUDGEMENT – we looked at outcomes for the following standard(s):

The management systems for the service are sound and well implemented.

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JUDGEMENT – we looked at outcomes for the following standard(s):

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 18 Staff and foster carers are well managed and supported, and records are appropriately maintained. Foster carers’ training needs are very well met.

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EVIDENCE:

The statement of purpose has been reviewed and updated since the last inspection visit. Children and young people who use the service have been involved in redesigning the children’s guide. The foster carer handbook has also been reviewed and updated.

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EVIDENCE:

The registered manager, and responsible individual, for the service are unchanged. The registered manager is a qualified social worker with previous experience of managing this type of service and other community, and residential, social care services. The service receives support from the national NCH organisation in relation to finances and financial processes; general health and safety responsibilities; IT services; HR and staff recruitment procedures; and core training for staff. NCH employs a fostering advisor who assists the manager in keeping up-to-date with changes in legislation and practice issues, as well as ensuring that she has information about conferences and training opportunities for continuing professional development. The manager is also a member of the NCH fostering sub-group where representatives of all NCH fostering services meet twice yearly to keep up-to-date with current practice

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EVIDENCE:

and quality assurance issues. The registered manager’s line manager, the NCH project development manager based in the NCH regional office in Bristol, provides her with professional support and monthly one-to-one supervision and deputises in her absence.

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EVIDENCE:

Qualified social work input into the staff team has improved since the previous inspection visit and the service is now fully staffed, with the full-time equivalent of 3.6 qualified social worker posts (covered by one full-time and four part-time social workers), to support, and supervise, up to 40 approved fostering households. The social workers also undertake recruitment and assessment of new foster carers, up to a maximum of three on-going assessments, at any one time. The service also employs a full-time paediatric nurse (who gives support and training to foster carers on specific health and nursing care for children and young people using the service) and two full- time, experienced and knowledgeable care coordinators (who collate information about children’s individual needs for the matching and placement planning processes; liaise with the children and young people using the service and their families, and the local authority care manager; and assist the social

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EVIDENCE:

workers with the assessment and training of new foster carers, and the reviewing of approved fostering households).

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EVIDENCE:

Staff confirmed to the inspector that they receive regular one-to-one supervision from the manager of the service. Regular team meetings, at which minutes are taken, are held. Staff confirmed to the inspector that they are able

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EVIDENCE:

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 19 to access NCH policies and procedures via the NCH intranet. The inspector interviewed two staff appointed to the service since the last inspection visit. These discussions confirmed the recruitment and induction procedures, which were thorough. Staff said that they felt well supported by the manager of the service and other members of the staff team.

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EVIDENCE:

Responses to the foster carer questionnaire survey showed that foster carers feel well supported by the service, with help and advice available when they need it. Discussions with staff, and inspection of two foster carer files, confirmed that supervising social workers are undertaking unannounced visits to foster homes, as well as planned visits to support and supervise foster carers.

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EVIDENCE:

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SCORING OF OUTCOMES

This page summarises the assessment of the extent to which the National Minimum Standards for Fostering Services have been met and uses the following scale.

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SCORING OF OUTCOMES

4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable

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SCORING OF OUTCOMES

BEING HEALTHY ACHIEVING ECONOMIC Standard No Score WELLBEING 12 4 Standard No Score 14 X STAYING SAFE 29 3 Standard No Score 3 3 MANAGEMENT 6 3 Standard No Score 8 4 1 3 9 3 2 3 15 3 4 X 30 1 5 X 16 3 ENJOYING AND ACHIEVING 17 3 Standard No Score 18 X 7 4 19 X 13 X 20 3 31 4 21 3 22 3 MAKING A POSITIVE 23 4 CONTRIBUTION 24 3 Standard No Score 25 3 10 3 26 3 11 3 27 X 28 X 32 N/A

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SCORING OF OUTCOMES

NCH Devon Family Based Short Break Service SC_SC064273_20070122.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO

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STATUTORY REQUIREMENTS

This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Fostering Services Regulations 2002 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales.

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STATUTORY REQUIREMENTS

No. Standard Regulation Requirement Timescale for action 1. FS30 25 The fostering service must ensure that no business is conducted by the fostering panel unless at least five of its members, including the person appointed to chair the panel, or the vice chair, at least one of the social workers employed by the fostering service and at least two of the independent members, meet as a panel. 25/01/07

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RECOMMENDATIONS

These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out.

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RECOMMENDATIONS

No. Refer to Standard Good Practice Recommendations

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RECOMMENDATIONS

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Commission for Social Care Inspection

Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP

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Commission for Social Care Inspection

National Enquiry Line Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI

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