Setting

Cedar House School

Kirkby Lonsdale Carnforth Lancashire LA6 2HW

p.1

Cedar House School

7th & 8th February 2005 Residential Special School (not registered as a Children’s Home)

p.1

Commission for Social Care Inspection

Launched in April 2004, the Commission for Social Care Inspection (CSCI) is the single inspectorate for social care in England.

p.2

Commission for Social Care Inspection

The Commission combines the work formerly done by the Social Services Inspectorate (SSI), the SSI/Audit Commission Joint Review Team and the National Care Standards Commission.

p.2

The role of CSCI is to:

• Promote improvement in social care • Inspect all social care - for adults and children - in the public, private and voluntary sectors • Publish annual reports to Parliament on the performance of social care and on the state of the social care market • Inspect and assess ‘Value for Money’ of council social services • Hold performance statistics on social care • Publish the ‘star ratings’ for council social services • Register and inspect services against national standards • Host the Children’s Rights Director role.

p.2

Inspection Methods & Findings

SECTION B of this report summarises key findings and evidence from this inspection. The following 4-point scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase "Standard met?"

p.2

The 4-point scale ranges from:

4 - Standard Exceeded (Commendable) 3 - Standard Met (No Shortfalls) 2 - Standard Almost Met (Minor Shortfalls) 1 - Standard Not Met (Major Shortfalls) 'O' or blank in the 'Standard met?' box denotes standard not assessed on this occasion. '9' in the 'Standard met?' box denotes standard not applicable. 'X' is used where a percentage value or numerical value is not applicable. Cedar House School Page 1

p.2

Fax No: Address

Kirkby Lonsdale, Carnforth, Lancashire, LA6 2HW Email Address:

p.3

Residential Special School

Date of last boarding welfare inspection: 26/11/03

p.3

Residential Special School

Date of Inspection Visit 7 th & 8 th February 2005 ID Code

p.3

Residential Special School

Name of CSCI Inspector 1 Mr Stewart Waddell 121431

p.3

Residential Special School

Name of CSCI Inspector 2 Mrs Cath Wilson 072824

p.3

time of inspection

Ms Gillian Ridgway & Mr Drew Campbell Cedar House School Page 2

p.3

INTRODUCTION TO REPORT AND INSPECTION

Residential Special Schools are subject to inspection by the Commission for Social Care Inspection (CSCI) to determine whether the welfare of children (i.e. those aged under 18) is adequately safeguarded and promoted while they are accommodated by the school.

p.5

INTRODUCTION TO REPORT AND INSPECTION

Inspections assess the extent to which the school is meeting the National Minimum Standards for Residential Special Schools, published by the Secretary of State under Section 87C of the Children Act 1989, and other relevant requirements of the Children Act 1989 as amended. Residential Special Schools are not registered as children’s homes unless they accommodate, or arrange accommodation for, one or more children for more than 295 days a year.

p.5

INTRODUCTION TO REPORT AND INSPECTION

This document summarises the inspection findings of the CSCI in respect of Cedar House School The report follows the format of the National Minimum Standards and the numbering shown in the report corresponds to that of the standards.

p.5

INTRODUCTION TO REPORT AND INSPECTION

• Inspection methods used • Key findings and evidence • Overall ratings in relation to the standards • Recommended action by the school • Advisory recommendations on boarding welfare • Summary of the findings • Report of the lay assessor (where relevant) • The Head’s response and proposed action plan to address findings

p.5

INSPECTION VISITS

Inspections are undertaken in line with the agreed regulatory framework under the Care Standards Act 2000 and the Children Act 1989 as amended, with additional visits as required.

p.5

INSPECTION VISITS

The report represents the inspector's findings from the evidence found at the specified inspection dates. Cedar House School Page 4

p.5

BRIEF DESCRIPTION OF THE SCHOOL AND RESIDENTIAL PROVISION

Cedar House is a co-educational special school for children exhibiting emotional and behavioural difficulties. The school caters for 86 children aged 7 to 17 years on a day or residential basis. At the time of inspection the youngest pupil was 10 years of age, the eldest 16 years of age. The school is situated close to the centre of the market town of Kirkby Lonsdale, which is within easy travelling distance of the larger towns of Kendal and Morecambe, and the city of Lancaster.

p.6

BRIEF DESCRIPTION OF THE SCHOOL AND RESIDENTIAL PROVISION

The residential provision comprises of 5 units, four for boys and one for girls. This includes Lowgate House a purpose built house that provides accommodation for the Junior boys. The school was currently embarked on a building programme, adding new classroom facilities. Further expansion was planned – as part of which the school hope to provide a recreation hall area, and refurbish and redecorate assembly and dining hall areas.

p.6

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

Cedar House School Page 5 The school benefited from having an experienced and capable senior management team, both the head teacher and the head of care having been in post for some time. All staff spoken to during the inspection were positive in their comments about the support they received from senior staff, and the access they had to management to discuss any issues.

p.7

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

The school had an admissions process that was child centred and provided additional support and guidance during pupil’s initial “settling in” period at the school. All young people interviewed stated they were fully aware of what residential unit they would be accommodated in before coming to the school, and had been provided with documentation and information about the school’s operation, rules and guidelines. Pre-inspection questionnaire’s returned by placing authorities stated that the school worked “very well” with placing authorities and kept them fully informed of all relevant incidents.

p.7

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

There was evidence to show that staff utilised young people’s Individual Care and Education Plans as effective working tools. Care plans addressed all relevant areas required, and “Individual Action Plans” clearly targeted objectives to be achieved and strategies to meet those objectives. There were various forums in which young people could express their views on issues that affected their daily lives. Young people and staff were aware of the school’s complaints procedures and evidenced viewed that these procedures had been accessed. All staff had received appropriate child protection training. All relevant child protection issues had been appropriately referred and the “Named Person” for child protection issues had kept a detailed record of such referrals, and the outcome of any subsequent investigation.

p.7

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

Young people interviewed stated bullying was not an issue at the school and no young person raised any such issue with inspectors during the inspection.

p.7

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

Young people had a clear understanding of the school’s points and grading systems and were able to detail these to the inspectors. There were clearly set out boundaries and guidelines, consistently applied, which were well understood by both staff and young people. Young people were generally very positive in their comments about the school, the staff that worked with them, and the standard of care they received. 13 parents/carers returned pre – inspection questionnaires in which the majority stated they were very pleased with the care provided at the school for their child. Key workers maintained weekly contact with parents/carers, keeping them informed of all relevant issues. All young people, where practically possible, received regular weekend home leave – some young people going home each weekend.

p.7

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

The standard of accommodation provided was generally of a very appropriate and acceptable standard – with many bedrooms having en-suite facilities. There was good evidence to show all appropriate health & safety standards were appropriately met. A varied, balanced menu was provided and young people commented favourably on the food they received. The school had it’s own dedicated nurse who ensured all young people received appropriate health care.

p.7

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

There was evidence to show all young people received individual support if and when required. The school had it’s own Educational Psychologist and regular access to speech therapists and play therapists, as well as the local area CAMHS team.

p.7

WHAT THE SCHOOL DOES WELL IN BOARDING WELFARE

The senior management team had developed very detailed systems to assist them to Cedar House School Page 6 monitor the running of the school very closely and Regulation 33 visits were carried out with the frequency required. Detailed reports from such visits were provided and the school compiled an action plan to address issues raised in each report. There was good evidence to show the school was efficiently managed and run, and documentation and records viewed throughout the inspection were generally of a very acceptable standard.

p.7

WHAT THE SCHOOL SHOULD DO BETTER IN BOARDING WELFARE

Staff interviewed stated the school would benefit from the provision of extra recreational space within the main campus – the lack of adequate space restricting the leisure activities they could offer on site. The school hope to erect a recreation/gym hall to address this, but this may be subject to planning permission from the local authority. Inspectors discussed with the Head of Care the possibility of expanding the “Leavers Programme” for young people who were in their last year at school. .

p.8

CONCLUSIONS AND OVERVIEW OF FINDINGS ON BOARDING WELFARE

The inspectors view was that Cedar House School provided a very acceptable and appropriate level of care for the young people accommodated. There were appropriate practices, policies and procedures in place, and operating, that ensured young people’s welfare was both promoted and protected. Pre-inspection questionnaires received evidenced that placing authorities, parents/carers and other professionals involved with the school, were positive about the service provided. Young people interviewed during inspection were positive in their comment s about the school, the staff and the care they received – younger pupils being extremely positive in their comments. The inspectors observed care staff to work positively with young people, and employ appropriate and acceptable working practices throughout the inspection. The Head of Care managed and led the care staff team capably and efficiently, and demonstrated appropriate knowledge of school practices, policies and

p.8

CONCLUSIONS AND OVERVIEW OF FINDINGS ON BOARDING WELFARE

procedures. The Head Teacher and the Head of Care worked closely together and staff interviewed stated that both were always available to discuss issues. There was good evidence to show that senior management closely monitored the operation of the school on a regular basis, and documentation and records viewed were of a very acceptable standard Cedar House School Page 7

p.8

Children Act 1989 arising from this inspection?

Notification to be made to: Local Education Authority NO Secretary of State NO

p.9

IMPLEMENTATION OF RECOMMENDED ACTIONS FROM LAST INSPECTION

Recommended Actions from the last Inspection visit fully implemented? YES

p.9

implemented are listed below:

No Standard Recommended actions Timescale for action Cedar House School Page 8

p.9

which indicates how recommended actions are to be addressed. This action plan

will be made available on request to the Area Office.

p.10

RECOMMENDED ACTION

Identified below are the actions recommended on issues addressed in the main body of the report in order to safeguard and promote the welfare of boarders adequately in accordance with the National Minimum Standards for Residential Special Schools. The references below are to the relevant Standards. Non-implementation of recommended action can lead to future statutory notification of failure to safeguard and promote welfare. No Standard* Recommended Action Timescale for action 1 RS 14 Medication policies and procedures should be reviewed to include self-medication and to ensure the use of labelled child resistant containers for secondary dispensing for weekend leave. 07/05/05

p.10

RECOMMENDED ACTION

2 RS 14 It is recommended that medical files also include risk assessment of children for self-medication, and a list of all current medication 07/05/05

p.10

RECOMMENDED ACTION

3 RS 14 It is recommended that the provision of information relating to medicines for other staff be formalised, and that information held on units be expanded to include particular cautions and possible adverse effects of medication. It is also recommended children’s names and medication lists are removed from the front of cabinets to maintain confidentiality. 07/05/05

p.10

RECOMMENDED ACTION

4 RS 14 It is recommended that the use of drug names is consistent, so that the name on the dispensed medicine matches that used in records to prevent confusion. MARs sheets used should be accurate for prescribed medication, and medicines should be administered as prescribed. 07/05/05

p.10

RECOMMENDED ACTION

5 RS 14 It is recommended that the any fridge used for the storage of medication be locked, and that daily temperatures be recorded, that should be maintained within the range of 2 to 8ºC. 07/05/05 Cedar House School Page 9 6 RS 30 The school should ensure all staff sign their own supervision records and receive copies of the minutes of each supervision session. 07/05/05

p.10

RECOMMENDED ACTION

7 RS 30 The school should hold full staff meetings at least once per school term. 07/05/05

p.11

RECOMMENDED ACTION

8 RS 31 The school should demonstrate how it intends to meet the recommendation of having 80% of its care staff team appropriately qualified. 07/05/05

p.11

ADVISORY RECOMMENDATIONS

Identified below are advisory recommendations on welfare matters addressed in the main body of the report and based on the National Minimum Standards, made for consideration by the school. No Refer to Standard* Recommendation

p.11

ADVISORY RECOMMENDATIONS

1 RS 16 The school should consider providing individual lockable storage space for each young person to store personal possessions within their bedroom areas.

p.11

ADVISORY RECOMMENDATIONS

Note: You may refer to the relevant standard in the remainder of the report by omitting the 2-letter prefix. E.g. RS10 refers to standard 10. Cedar House School Page 10

p.11

PART B INSPECTION METHODS AND FINDINGS

The following inspection methods were used in the production of this report

p.12

PART B INSPECTION METHODS AND FINDINGS

Direct Observation YES Pupil Guided Tour of Accommodation YES Pupil Guided Tour of Recreational Areas YES

p.12

PART B INSPECTION METHODS AND FINDINGS

Checks with other Organisations • Social Services YES • Fire Service YES • Environmental Health YES • DfES YES • School Doctor YES • Independent Person YES • Chair of Governors NA Tracking individual welfare arrangements YES Survey / individual discussions with boarders YES Group discussions with boarders YES Individual interviews with key staff YES Group interviews with House staff teams YES Staff Survey YES Meals taken with pupils YES Early morning and late evening visits YES Visit to Sanatorium / Sick Bay YES Parent Survey YES Placing authority survey YES Inspection of policy/practice documents YES Inspection of records YES Individual interview with pupil(s) NO Answer-phone line for pupil/staff comments NO

p.12

PART B INSPECTION METHODS AND FINDINGS

Date of Inspection 07/02/05 Time of Inspection 09.15 Duration Of Inspection (hrs.) 22 Number of Inspector Days spent on site 2

p.12

Pre-inspection information and the Head’s Self evaluation Form, provided by the

school, have also been taken into account in preparing this report. Cedar House School Page 11

p.12

SCHOOL INFORMATION

Age Range of Boarding Pupils From 7 To 17

p.13

NUMBER OF BOARDERS AT TIME OF INSPECTION:

The following pages summarise the key findings and evidence from this inspection, together with the CSCI assessment of the extent to which standards have been met. The following scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase "Standard met?"

p.13

NUMBER OF BOARDERS AT TIME OF INSPECTION:

The scale ranges from: 4 - Standard Exceeded (Commendable) 3 - Standard Met (No Shortfalls) 2 - Standard Almost Met (Minor Shortfalls) 1 - Standard Not Met (Major Shortfalls)

p.13

NUMBER OF BOARDERS AT TIME OF INSPECTION:

"0" in the "Standard met" box denotes standard not assessed on this occasion. "9" in the "Standard met" box denotes standard not applicable. “X” is used where a percentage value or numerical value is not applicable. Cedar House School Page 12

p.13

The intended outcome for the following standard is:

• Children, parents, staff and placing authorities have access to a clear statement of the school's care principles and practice for boarding pupils.

p.14

Approved Arrangements and school prospectus, which are required to include

specific information. Key Findings and Evidence Standard met? 3 The school’s Statement of Purpose had been reviewed in November 2004. Required minor amendments to this document, and to the school’s Pupil’s Handbook were made during the inspection. The “Pupil Handbook” was a detailed and informative document that provided young people with relevant information set out in a “user friendly” format. Cedar House School Page 13

p.14

The intended outcomes for the following set of standards are:

• Children are encouraged and supported to make decisions about their lives

p.15

and to influence the way that the school is run. No child should be assumed

to be unable to communicate their views. • Children's privacy is respected and information about them is confidentially handled. • Children's complaints are addressed without delay and children are kept informed of progress in their consideration.

p.15

key decisions which are likely to affect their daily life and their future. Feedback is

given following consultations. Key Findings and Evidence Standard met? 3 There was evidence to show that young people were regularly consulted about matters that may affect their daily lives. Each residential unit held weekly residents meetings. The minutes of each meeting were recorded. Inspectors viewed the minutes of meetings held in each residential unit. Each residential unit elected a young person from their unit to be their representative on the school council, which met once per term with the Head Teacher and Head of Care. Young people met at least fortnightly with their key worker – inspectors viewed minutes of these sessions. Key workers maintained weekly telephone contact with parents/carers and, if applicable, senior staff maintained weekly contact with placing social workers. Replies to pre-inspection questionnaires sent to placing authorities evidenced that such authorities were of the opinion that the school worked with them “very well”.

p.15

The school and staff respect a child's wish for privacy and confidentiality so far as is

consistent with good parenting and the need to protect the child. Key Findings and Evidence Standard met? 3 The school had appropriate policies and procedures in place for staff regarding privacy and confidentiality. Staff were observed to work with appropriate regard for young people’s privacy. All residential units contained payphones sited in areas that afforded adequate privacy for users. Young people were permitted to have mobile phones, subject to agreement on use. Mobile “picture phones” were not allowed and an issue raised by young people about staff having such phones was addressed by senior staff during inspection. Amendments required to the documentation for recording any searches of young people’s possessions were made during the inspection, and the documentation now met the requirements Standard 3.11. Cedar House School Page 14

p.15

living in the school, and feel confident that any complaint is addressed seriously and

without delay. Key Findings and Evidence Standard met? 3 The pupil handbook contained a section on the school’s complaints procedure covering the formal and informal procedure. The procedure adequately detailed the role of the Commission for Social Care Inspection in the complaints process and contained the telephone number of the local area office. The handbook also contained a list of telephone numbers of outside agencies available to young people, including CSCI. A similar list was also placed in each payphone cubicle. Care staff had received appropriate guidance on the complaint’s procedure and detailed to inspectors how they would process a formal complaint received from a young person. Three formal complaints had been recorded since the last inspection – the last of those on 20/06/04. During interviews with inspectors young people stated they knew how to make a complaint, and they were of the opinion staff would address

p.16

months:

Number of above complaints substantiated: 1

p.16

months:

Number of above complaints substantiated: 0 Cedar House School Page 15

p.16

The intended outcomes for the following set of standards are:

• The welfare of children is promoted, children are protected from abuse, and an appropriate response is made to any allegation or suspicion of abuse. • Children are protected from bullying by others. • All significant events relating to the protection of children accommodated in

p.17

the school are notified by the Head of the school to the appropriate

authorities. • Children who are absent without authority are protected in accordance with written guidance and responded positively to on return.

p.17

suspicions or allegations of abuse are properly responded to. These are known and

understood by all staff (including junior, ancillary, volunteer and agency staff). Key Findings and Evidence Standard met? 3 The school had a detailed, written child protection policy. The policy gave clear guidance for staff. Since the last inspection the “Named Person” for child protection issues had undergone a four-day training course, delivered by an NSPCC training officer. All staff received basic child protection training during their induction programme – including ancillary staff. This was followed up by a full one-day training course at a later date. Care staff and ancillary staff responded appropriately to child protection scenario’s set by inspectors. The school had diligently referred any possible child protection issues to the relevant agencies. A detailed record was kept of all referrals and of the outcome to any subsequent investigation. In a written reply to a pre-inspection letter sent, the local social services team receiving referrals

p.17

suspicions or allegations of abuse are properly responded to. These are known and

stated “It would appear that correct child protection procedures had been followed”.

p.17

familiar and which is effective in practice. Where possible children in the school

contribute to the development of the policy. Key Findings and Evidence Standard met? 3 The school had appropriate policies and procedures in place to address issues of bullying. Any issues of bullying were addressed and senior staff monitored any such incident s regularly. Risk assessments on any potential bullying, and the places where it may be most likely to occur, had been carried out and regularly reviewed. During interviews with the inspectors, young people stated bullying was not an issue at the school and felt that staff would address any such issue if it was brought to their attention.

p.18

familiar and which is effective in practice. Where possible children in the school

Percentage of pupils reporting never or hardly ever being bullied 98 %

p.18

All significant events relating to the protection of children in the school are notified by

the Head of the school or designated person to the appropriate authorities. Key Findings and Evidence Standard met? 3 Documentation viewed evidenced that the school had been diligent in appropriately notifying relevant agencies of any significant incident. The school kept a detailed record of all such incidents referred – the incident reported, date reported, and to whom reported. The outcome of any investigation initiated by a notification was also appropriately recorded.

p.18

NUMBER OF THE FOLLOWING NOTIFIED TO CSCI DURING THE LAST 12 MONTHS:

• conduct by member of staff indicating unsuitability to work with children 0 • serious harm to a child 0 • serious illness or accident of a child 3 • serious incident requiring police to be called 6 Cedar House School Page 17

p.18

The school takes steps to ensure that children who are absent from the school

without consent are protected in line with written policy and guidance. Key Findings and Evidence Standard met? 3 The school accurately recorded all such incidents – including many incidents where young people had absented themselves from class for a short period of time and returned of their own volition. The overwhelming majority of any incident of absconding behaviour occurred during the school day – incidents of absconding during care hours were rare. The documentation for recording any such incidents required minor amendments – these were made during the inspection. The school had developed effective procedures and systems for monitoring all such incidents.

p.19

The intended outcomes for the following set of standards are:

• Children have sound relationships with staff based on honesty and mutual respect. • Children are assisted to develop appropriate behaviour through the

p.20

understanding and clear professional and personal boundaries which are effective for

both the individuals and the group. Key Findings and Evidence Standard met? 3 Inspectors observed appropriate and positive interactions between staff and young people. It appeared staff had established positive working relationships with young people. Staff and young people were seen to communicate in a friendly manner with humour prevalent. During interviews with inspectors young people commented favourably about the care staff who worked with them. Appropriate risk assessments had been carried out on staff working alone with young people. 13 parents/carers completed and returned pre-inspection questionnaire’s in which 9 stated they were “very happy” with the care their child received, 3 were “quite happy” and one felt the care received was “okay”. Cedar House School Page 19

p.20

is regarded as unacceptable by staff, it is responded to by constructive disciplinary

measures which are approved by the Head of Care. Key Findings and Evidence Standard met? 3 All staff had received training in the school’s preferred method of positive intervention – “Team Teach”. The Head Teacher and Head of Care were senior instructors in this method and regular refresher courses were held for staff. Staff interviewed accurately detailed when it may be appropriate to use any form of physical restraint. The school operated a “grades” system to encourage young people to meet their personal goals as well as maintain an acceptable level of behaviour. Young people clearly understood the grading process and detailed it to inspectors during the inspection. Sanctions were applied for unacceptable behaviours – young people detailed the tariff of sanctions to inspectors. Staff interviewed stated they tried to avoid the use of sanctions wherever possible, preferring to use more positive measures. Written records of any sanctions applied were kept – minor amendments

p.21

is regarded as unacceptable by staff, it is responded to by constructive disciplinary

required to this documentation were made during the inspection. Records of physical restraints examined were cross- referenced with other relevant documentation. Some concerns were raised about the possible use of a “CS” room – a “time out” room – during care hours, for young people from residential units sited away from the main building. However staff interviewed suitably addressed these concerns. The inspectors were informed this room was to become part of a larger music room as part of the school’s rebuilding programme. The school had a clear policy for the involvement of police in any issues of young people found with drugs or illegal substances. Cedar House School Page 20

p.21

The intended outcomes for the following set of standards are:

• Children experience planned and sensitively handled admission and leaving processes. • The school's residential provision actively supports children's educational progress at the school. • Children have ample opportunity to engage in purposeful and enjoyable activities both within school and in the local community. • Children live in a healthy environment and the health and intimate care needs of each child are identified and promoted. • Children are provided with healthy, nutritious meals that meet their dietary needs. • Children wear their own clothing outside school time, can secure personal

p.22

appropriate, with parents and carers and placing authorities – as far as possible and

handled with sensitivity and care by those concerned. Key Findings and Evidence Standard met? 3 Inspectors interviewed the school’s “Pupil Liaison Officer” who had a pivotal role in the school’s admissions policy, and in providing initial staff support to new pupils. All young people interviewed stated they had visited the school before admission. They also stated they were all aware of which residential unit they would be accommodated in, and had received the pupil handbook and other relevant information about the school, before admission. Young people also commented favourably on the support they received from the Pupil Liaison Officer, and other staff, when they were first accommodated at the school. The school had developed a “Leavers Programme” for senior pupils who were in their last year at school, aimed at promoting their independent living skills. Inspectors were informed the school were considering extending this to cover year 10 pupils. Inspectors discussed the

p.22

appropriate, with parents and carers and placing authorities – as far as possible and

possibility of expanding some areas of the programme with the Head of Care. The Connexions organisation worked closely with the school – coming in to the school weekly to work with year 10 and 11 pupils as part of the “Leavers Programme”. Cedar House School Page 21

p.22

education, ensuring regular attendance, punctuality and a minimum of interruption

during the school day. Key Findings and Evidence Standard met? 3 All young people had an “Individual Care and Education Programme” compiled specifically for them, detailing care and education needs, and how these would be addressed. Some young people were studying for GCSE’s. There were suitable areas for private study if required. Care staff were allocated working hours during the classroom day to support teaching staff and some staff from the education department worked care hour duties. All young people accommodated at the school attended school for education on each day of the inspection

p.23

Children have ample opportunity to engage in purposeful and enjoyable activities

both within the school and in the local community. Key Findings and Evidence Standard met? 3 Young people commented favourably about the range of activities on offer at the school – some specifically commenting on the activities provided at weekends when there were fewer young people resident. All activities were risk assessed and where appropriate, a qualified adult supervised them. Young people were encouraged to join local youth groups if they wished. Young people interviewed stated activities offered included cinema visits, ten-pin bowling and swimming. Each residential unit had “X boxes”, “Play stations” and computer games as well as tv, dvd and video machines. Staff ensured any games played, or video or dvd viewed, was age appropriate. Some young people stated they would like Sky Satellite TV installed. Some staff and young people commented on the lack of recreational space on the main school campus. At the time of the inspection the outdoor facilities consisted of a

p.23

Children have ample opportunity to engage in purposeful and enjoyable activities

fenced tennis court area, an adventure play area for the junior pupils, and a football field adjacent to the Westmorland and Lonsdale residential units. Senior staff interviewed stated the school hoped to erect a recreation/gym hall adjacent to the main building, but this was dependent on planning permission being received.

p.23

The school actively promotes the health care of each child and meets any intimate

care needs. Key Findings and Evidence Standard met? 2 The school employed a part-time nurse with responsibility for handling medicines, and had a system for following-up any medical interventions arising during her absence. There were many examples of good practice seen and issues raised were mainly around formalising systems and ensuring appropriate documentation was kept. Policies and procedures were inspected that were adequate but certain aspects required review including inclusion of a self-medication policy, particularly with respect to older children and encouraging them to take control of medicines in preparation for leaving school. The policy also included secondary dispensing for weekend leave and this should be reviewed to ensure that appropriately labelled, child resistant containers are used. Parents or guardians completed a Cedar House School Page 22 medical form providing information on medical histories, current medication, allergies,

p.23

The school actively promotes the health care of each child and meets any intimate

immunisations and giving consent for medical treatment, examinations, immunisations, dental and optician checks and out-door activities, and these were generally complete. However, consents did not include the administration of non-prescribed medication but the inspector was informed that this was under review with the GP. Password protected computer records were also maintained. A sample of care plans and records were inspected. There was evidence of appropriate monitoring and review for specific medicines as recommended by specialists. All medical, dental and optician interventions were recorded and records of accidents were maintained that were cross-referenced with the accident book and physical incident forms where necessary. Children were able to self-medicate where appropriate. The nurse undertook risk assessment but this needed formalising and documenting. Medicines were stored in the surgery, and on each of the five residential units,

p.24

The school actively promotes the health care of each child and meets any intimate

and only senior staff had access. The surgery stored excess medicines and Controlled Drugs. Medicine keys were secured when not in use. The inspector found that storage in the surgery, and the two units checked, was appropriate. The administration of Controlled Drugs was recorded in bound books and all administrations were witnessed. It is, however, recommended that the use of drug names is consistent so that names in records match those on dispensed medicines. A medicines fridge was in place and it is recommended that this be locked, and that daily temperatures be recorded, that should be maintained within the range of 2 to 8ºC. The inspector was informed that locked facilities would be made available for children who self-medicate. The nurse checked medicines on each unit once a week and replaced medicines administration records (MARs) that were then monitored. Each unit had a record of all currently prescribed medication for each child that was accurate. It is

p.24

The school actively promotes the health care of each child and meets any intimate

recommended that this also be logged in each child’s medical file. It is recommended that relevant information on medication be expanded to include particular cautions, for example water restriction following administration of desmopressin, and possible adverse effects necessitating review. A list of children and their medications was placed on the outside of the medicines cabinets and it is recommended that these be removed to maintain confidentiality. MAR charts were inspected and a number of errors were noted. A cream that was prescribed twice daily was administered once daily. Each day of leave from the school was not documented on the MAR leading to gaps where reasons for non-administration were not documented. The records were not specific for preparation or dosage. MARs charts should be accurate for prescribed medication and medicines should be administered as prescribed. All administrations were witnessed. All children were registered with a local

p.24

The school actively promotes the health care of each child and meets any intimate

medical practice but responsibility for overall management of specialist medicines remained with their consultant at home. One GP had overall responsibility for the school and held one surgery a week. Children were able to see a male or female GP. There was evidence of regular medication reviews. The school had good communications with the local pharmacist and optician, and the school health team who provided health education for children. The nurse demonstrated a good understanding of medicines, current issues and monitoring requirements. This was particularly evident with respect to a national safety alert relating to a specific medication that had been issued a few days earlier. Other staff were kept well informed of issues relating to medicines that may affect children, such as possible side effects or associated problems, though this needed formalising. The nurse had undertaken a four-day first-aid course and this was in the process of being

p.24

The school actively promotes the health care of each child and meets any intimate

delivered to senior staff. All other staff were receiving basic first-aid training. The inspector was advised that staff that handle medicines had received training in their safe handling. Cedar House School Page 23

p.24

health, religious persuasion, racial origin or cultural background are met, including

the choice of a vegetarian meal for children who wish it. Key Findings and Evidence Standard met? 3 Inspectors dined with young people in the school dining room and observed meal times in the residential units. Meal times observed were organised social occasions and the quality of food was appropriate and acceptable. A vegetarian option was always available as well as salads and fruit. In interview with the inspector the head cook stated young people who had particular dietary preferences or needs, could be catered for. Young people were observed to prepare themselves snack and drinks on the residential units. All care staff had received appropriate training in Basic Food Hygiene. The local Environmental Health Department had made an inspection visit to the school on 08/12/04 and found everything to be “satisfactory”. Inspectors viewed records of menus, and records of temperature logs for fridges and food

p.25

Children are provided for adequately on an individual basis and encouraged to

exercise their own preferences in the choice of clothing and personal requisites.

p.25

their money are provided with the assistance they need, in a way which maximises

their choice. Key Findings and Evidence Standard met? 3 The school provided all the school uniform clothing, and all bedding, linen, sleep attire, dressing gowns, school footwear etc. Some young people had brought their own duvet covers from home to use, thus personalising their bedroom areas. Young people wore their own leisure clothing and footwear during care hours. Pocket money was provided on a weekly basis - the amount given being dependent on age and the level the young person was on in the school’s grading system. Interviews with young people evidenced that they fully understood the pocket money and reward systems. Records of pocket money given were viewed by inspectors, and were appropriately maintained. Young people raised the issue of possibly receiving a personal allowance to purchase shampoo and other toiletries. Inspectors discussed this with the Head of Care and he stated the school would introduce

p.25

their money are provided with the assistance they need, in a way which maximises

such an allowance for young people on the “Leavers Programme”. Cedar House School Page 24

p.25

The intended outcomes for the following set of standards are:

• Children have their needs assessed and written plans outline how these needs will be met while at school. • Children's needs, development and progress is recorded to reflect their individuality and their group interactions. • There are adequate records of both the staff and child groups of the school. • In accordance with their wishes, children are able and encouraged to maintain contact with their parents and families while living away from home at school. • Children about to leave care are prepared for the transition into independent living. • Children receive individual support when they need it.

p.26

that child in accordance with that plan, monitors progress in relation to that plan, and

updates that plan as necessary. Key Findings and Evidence Standard met? 3 The school compiled Individual Care and Education Plans for each young person. Amendments required to the format were made during the inspection and the plans now covered all areas required under Standard 17.5 of the Residential Special Schools National Minimum Standards. Action plans for each young person were compiled, detailing needs to be addressed, and setting objectives and strategies to achieve them. Care staff used action plans as working tools. Keyworkers addressed needs and targets to be met with young people at their fortnightly meetings. Each young persons file contained a very detailed front sheet on each file containing all essential information at a glance. Where the school identified it necessary, Individual Behaviour Management Plans were formulated on young people who may require some sort of physical intervention on occasion.

p.26

which can, in compliance with legal requirements for safeguards, be seen by the

child. Key Findings and Evidence Standard met? 3 The school maintained a two-tiered filing system to hold information about pupils. The main files containing confidential information were maintained securely in a steel lockable filing cabinet, and the working files were kept in the care office where they could be accessed by all staff. Inspectors viewed a selection of young people’s files – the files viewed contained all relevant information required under this standard.

p.27

The school maintains clear and accurate records on the staff and child groups of the

school, and major events affecting the school and children resident there. Key Findings and Evidence Standard met? 3 Generally, the school maintained clear and accurate records on staff and young people, Documentation viewed was of a very acceptable standard. However, in the young people’s register, the school recorded “see parents address” in the section referring to where the young person was accommodated on their departure from the school – it is recommended the full actual address is recorded in this section.

p.27

to maintain contact with their parents and other family members (unless there are

welfare concerns) while living at school. Key Findings and Evidence Standard met? 3 Where appropriate, young people were actively encouraged to maintain regular contact with parents/carers and friends. Young people were able to use their mobile phones to maintain contact if they so wished, subject to agreeing to abide by the school’s guidelines on the use of mobile phones, and each residential unit had a payphone situated in an area that afforded suitable privacy. Young people also had access to facilities to e-mail home if they so wished. Key workers maintained weekly contact with parents/carers on a weekly basis to inform them of the individual young person’s progress. Wherever possible, young people at the school had weekend leave at least fortnightly – with some young people going home each weekend. Cedar House School Page 26

p.27

is expected to leave care or move to independent living. The school works with any

Personal Advisor for the child. Key Findings and Evidence Standard met? 3 The majority of young people’s placements were funded by their local Education Authority, with parents maintaining care responsibility. Where young people were in the LAC care system, arrangements would be made for appropriate pathway plans to be compiled and implemented, and the school would work closely with any Personal Advisors appointed to ensure that young people’s needs were met. The school had developed “Leavers Programmes” that young people in their final year at school followed – these being designed to develop independent living skills. The school had formed strong working links with the local office of the Connexions organisation who came in to school on a weekly basis to work with young people preparing to leave school.

p.28

children identified as having particular support needs, or particular problems, receive

help, guidance and support when needed or requested. Key Findings and Evidence Standard met? 3 There was evidence that young people received individual support and guidance when required. The parent organisation, the Witherslack Group, employed an Educational Psychologist, who visited the school each educational day to carry out individual work with young people, and assist and advise staff, as well as having an input in the assessment process. The school also had regular access to the services of local speech therapists and a play therapist, as well as access to the local area CAMHS team for support, services and advice. In addition to this, an independent listener was available for pupils to access. The independent listener replied to a pre-inspection letter sent and was very positive in their comments about the school and the care afforded to young people. Cedar House School Page 27

p.28

The intended outcomes for the following set of standards are:

• Children live in well designed, pleasant premises, providing sufficient space and facilities to meet their needs. • Children live in accommodation that is appropriately decorated, furnished and maintained to a high standard, providing adequate facilities for their use. • Children are able to carry out their ablutions in privacy and with dignity. • Children live in schools that provide physical safety and security.

p.29

environment most helpful to each child's development, and is sufficient for the

number of children. Key Findings and Evidence Standard met? 3 The school’s was located close to the centre of the market town of Kirby Lonsdale and all the facilities it offered. It was also within easy travelling distance of the larger towns of Kendal and Morecambe, and the city of Lancaster. Young people were accommodated in 5 separate residential units, each with it’s own facilities. All female residents were accommodated in one residential unit. The four residential units catering for male residents were organised due to the resident’s chronological age. The school had made a number of positive changes to the boarding accommodation over recent years. There were proposals for development in place to address the need to provide more recreational and leisure areas for young people. New classroom areas had already been developed and inspectors viewed these during inspection. Cedar House School Page 28

p.29

The school provides adequate good quality and well-maintained accommodation for

boarding pupils, which is consistent with their needs. Key Findings and Evidence Standard met? 3 Generally, the school provided a very acceptable standard of accommodation for young people. Although slightly restricted in some way by the physical layout of some of the buildings, the school had managed to create residential units that presented as homely living areas. Young people interviewed commented positively about their respective units – younger boys accommodated in Lowgate House held particularly positive views. All female resident s were accommodated in one residential unit – Borland unit – and this had been refurbished over a period of time to provide a spacious lounge area with a kitchen and dining area, and an independent training living area for 4 girls. Inspectors discussed with senior staff the possibility of installing some form of window blinds on the large lounge window to provide extra privacy. All the senior boys from the age of 14 upwards were accommodated in

p.30

The school provides adequate good quality and well-maintained accommodation for

Westmorland and Lonsdale units, which were situated opposite the main school. The majority of the bedrooms at the school offered en suite facilities. Generally, the residential units were well maintained through out, with only some minor areas of redecorating and repair required – the Site Manager detailing ways in which maintenance issues were addressed as promptly as possible to ensure the quality of accommodation was maintained.

p.30

suitable to meet the needs of the children. The school has appropriate changing and

washing facilities for incontinent children where necessary. Key Findings and Evidence Standard met? 3 Each residential unit contained sufficient bath, shower and toilet facilities for young people accommodated. All doors on such facilities had appropriate locks to afford privacy for users. Generally, all bathroom, shower and toilet areas were well decorated and well maintained. Cedar House School Page 29

p.30

and other hazards, in accordance with Health and Safety and Fire legislation and

guidance. Key Findings and Evidence Standard met? 3 Inspectors interviewed the Site Manager, who was also to assume the role of the nominated Health and Safety Officer on completion of a four-day Health & Safety training course. The current Health & Safety Officer had completed this course and inspectors interviewed him and the Site Manager jointly. Appropriate documentation was viewed. A weekly Health and Safety report was compiled. A Health and Safety check on all residential units and school areas was carried out each half term. The school had access to professional advice on all Health & Safety issues for an external consultancy firm based in Carlisle. The Fire Officer had carried out a service inspection on 21/01/05 and found everything satisfactory. Fire equipment checks had been carried out on 04/02/05 and fire alarm and emergency lighting systems checked by external consultants on 20/07/04. Fire alarm and emergency lighting

p.31

and other hazards, in accordance with Health and Safety and Fire legislation and

tests were carried out weekly and the results recorded. Appropriate fire drills had been carried out and recorded. All electrical appliances had been checked on 20/12/03, all gas installations checked on 20/12/04, and all boilers checked on 17/01/05. All appropriate risk assessments had been carried out and appropriately reviewed. All taps had been fitted with regulators to ensure hot water provided did not exceed 43 degrees C. Cedar House School Page 30

p.31

The intended outcomes for the following set of standards are:

• There are careful selection and vetting of all staff, volunteers, and monitoring

p.32

abusers

• Children are looked after by staff who understand their needs and are able to meet them consistently. • Children are looked after by staff who are trained to meet their needs. • Children are looked after by staff who are themselves supported and guided in safeguarding and promoting the children's welfare.

p.32

or Enhanced level as appropriate to their role in the school), with a satisfactory

outcome. There is a satisfactory recruitment process recorded in writing. Key Findings and Evidence Standard met? 3 The school’s recruitment process was detailed in the policy procedures manual. The files of all new staff employed since the last inspection were examined and met with the requirements of Standard 27 of the Residential Special Schools National Minimum Standards. Staff recruitment records were well maintained and well formatted with a written record of interviews and a note kept of the date of verification of references by direct contact with referees. Discussion took place with senior staff about the written request for reference letters sent by the school to referees. Senior staff stated they had received advice from the organisations lawyers that what the standards require to be in a reference letter may not be legally acceptable. Inspectors stated they would check this out with CSCI’s methodology

p.32

or Enhanced level as appropriate to their role in the school), with a satisfactory

managers. All staff employed had received appropriate CRB disclosure clearance before starting work.

p.32

specified under standard 28.2. Records of staff actually working in the school

demonstrate achievement of this staffing level. Key Findings and Evidence Standard met? 3 The Head of Care stated that the residential unit care staff teams operated on a staffing ratio of one staff to every four young people accommodated. Inspectors viewed staff rota’s that evidenced this level was being maintained and occasionally exceeded. Each duty team also had a “floating staff” member who could be directed to any residential unit who may require extra help. Each residential unit had a staff member on sleep in duty each night and two waking night staff patrolled the school throughout the night covering all unit areas. The Head of Care stated that the department was three staff members down and he was currently recruiting to fill these vacancies. However, staffing levels were being maintained using classroom support staff that wished to do some care hours, and care staff that wished to do overtime. The school were considering developing their own “bank staff” of care workers to

p.33

specified under standard 28.2. Records of staff actually working in the school

assist with covering any shortages or staff absences.

p.33

Staff receive training and development opportunities that equip them with the skills

required to meet the needs of the children and the purpose of the school. Key Findings and Evidence Standard met? 3 The school organised six “inset days” for staff, held immediately prior to the beginning of the school term. Relevant training courses were delivered during these days. Staff interviewed stated training needs were discussed during supervision sessions. The Head of Care assumed responsibility for the training programme for staff. He had devised a training grid analysis that covered all 21 areas of training required under Appendix 2 of the Residential Special Schools National Minimum Standards, allowing him to keep a personal training portfolio on each individual staff member. The school had developed an NVQ training programme that all staff had access to. All staff recruited completed an induction-training programme that covered all required areas. Staff interviewed stated that programmes of

p.33

Staff receive training and development opportunities that equip them with the skills

training had developed considerably over the last few years. Cedar House School Page 32

p.33

All staff, including domestic staff and the Head of the school, are properly

accountable and supported. Key Findings and Evidence Standard met? 2 From interviews with staff, and from records viewed, inspectors were able to evidence that supervision was being delivered with the frequency and duration required under Standard 30.2 of the Residential Special Schools National Minimum Standards. Unit leaders with responsibility for supervision of unit staff stated they had received training in supervision skills – discussion took place over the difficulty they sometimes had about fitting supervision sessions in to their timetables. Ancillary staff interviewed stated they did not sign their supervision records or receive copies of the minutes of supervision sessions. Care staff meetings were held fortnightly – however the school did not hold full staff meetings at least once every school term. The organisation had instigated a Performance Management System in place of formal annual staff appraisals. Staff interviewed were positive in their

p.34

All staff, including domestic staff and the Head of the school, are properly

comments about the support they received from the Head of Care and Head Teacher. Cedar House School Page 33

p.34

The intended outcomes for the following set of standards are:

• Children receive the care and services they need from competent staff. • Children enjoy the stability of efficiently run schools. • The governing body, trustees, local authority, proprietor or other responsible body monitors the welfare of the children in the school.

p.35

The school is organised, managed and staffed in a manner that delivers the best

possible childcare. Key Findings and Evidence Standard met? 2 The school benefited from having an experienced Head of Care and Head Teacher that had been in post for some years. The Head of Care held an appropriate NVQ 4 qualification in childcare and was currently completing an NVQ 4 in management. He was also an NVQ D32/33 assessor. 21 care staff were appropriately NVQ qualified with another 6 expected to complete their qualification by March 2005, taking the school to 71% of the care staff team suitably qualified. Documentation and records viewed and practice observed evidenced that the school was efficiently managed and run. Staff interviewed stated that they felt they could approach them the Head of Care or Head Teacher with any concerns or issues they had.

p.35

must make sure that the operation of the school meets the requirements of these

standards in relation to the day to day running of the school. Key Findings and Evidence Standard met? 3 The inspectors viewed records and documentation that evidenced senior managers at the school regularly monitored and reviewed relevant practices. The school had developed sound and efficient monitoring systems that enabled any areas of concern to be readily highlighted. There was evidence to show that senior staff had monitored all areas required under Standard 32.2 of the Residential Special School National Minimum Standards, and with the frequency demanded by the standard. The Head Teacher produced a written report on the operation of the school each term, this report then being forwarded to the organisations board of directors. Cedar House School Page 34

p.35

receive a written report on the conduct of the school from a person visiting the school

on their behalf every half term. Key Findings and Evidence Standard met? 3 Monitoring visits were carried out on a half termly basis - complying with the frequency demanded by this standard. The organisations “Quality Assurance” team carried out these visits. A full written report was compiled and forwarded to the school. The Head Teacher was required to formulate an action plan in response to each report, addressing any issues raised in the report. Inspectors viewed copies of both documents. Cedar House School Page 35

p.36

Date

Lead Inspector… Stewart Waddell Signature……………………………….

p.37

Date

Second Inspector… Cath Wilson Signature……………………………….

p.37

Date

Locality Manager… Penny Wilkinson Signature……………………………….

p.37

Date

Date… 10 June 2005 Cedar House School Page 36

p.37

D.1 Head’s comments/confirmation relating to the content and accuracy of the

We would welcome comments on the content of this report relating to the Announced Inspection of Cedar House School conducted on 07 & 08 February 2005 and any factual inaccuracies:

p.38

D.1 Head’s comments/confirmation relating to the content and accuracy of the

Please limit your comments to one side of A4 if possible Provider’s comments and an action plan are available at the CSCI office, Penrith. Cedar House School Page 37

p.38

Action taken by the CSCI in response to Head’s comments:

Amendments to the report were necessary YES

p.39

Action taken by the CSCI in response to Head’s comments:

Comments were received from the provider YES

p.39

Action taken by the CSCI in response to Head’s comments:

Head’s comments/factual amendments were incorporated into the final inspection report YES

p.39

Action taken by the CSCI in response to Head’s comments:

Head’s comments are available on file at the Area Office but have not been incorporated into the final inspection report. The inspector believes the report to be factually accurate

p.39

Note:

In instances where there is a major difference of view between the Inspector and the Head both views will be made available on request to the Area Office.

p.39

advisory recommendations are to be addressed and stating a clear timescale

for completion. This will be kept on file and made available on request.

p.39

Status of the Head’s Action Plan at time of publication of the final inspection report:

Action plan was received at the point of publication YES

p.39

Status of the Head’s Action Plan at time of publication of the final inspection report:

Action plan covers all the statutory requirements in a timely fashion YES

p.39

Status of the Head’s Action Plan at time of publication of the final inspection report:

Action plan did not cover all the statutory requirements and required further discussion

p.39

Status of the Head’s Action Plan at time of publication of the final inspection report:

Provider has declined to provide an action plan

p.39

Date

Note: In instance where there is a profound difference of view between the Inspector and the Head both views will be reported. Please attach any extra pages, as applicable.

p.40

Cedar House School / 7th & 8th February 2005

Commission for Social Care Inspection 33 Greycoat Street London SW1P 2QF

p.41

Cedar House School / 7th & 8th February 2005

Telephone: 020 7979 2000 Fax: 020 7979 2111

p.41

Cedar House School / 7th & 8th February 2005

National Enquiry Line: 0845 015 0120 www.csci.org.uk

p.41

Cedar House School / 7th & 8th February 2005

S0000040058.V232675.R01 © This report may only be used in its entirety. Extracts may not be used or reproduced without the express permission of the Commission for Social Care Inspection

p.41

Cedar House School / 7th & 8th February 2005

The paper used in this document is supplied from a sustainable source

p.41