Setting

Cares (NFP) Ltd T/A Foster Cares

Thomas Wright House High Street Byers Green Durham DL16 7PF

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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.

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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.

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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.

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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?"

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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. Cares (NFP) Ltd T/A Foster Cares Page 1

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Fax No Address

Thomas Wright House, High Street, Byers Green, Durham, DL16 7PF

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Date of latest registration certificate

Date of last inspection 3/11/2003 Cares (NFP) Ltd T/A Foster Cares Page 2 Date of Inspection Visit 22nd November 2004 ID Code

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Date of latest registration certificate

Name of Inspector 1 Michele Hargan 076522

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inspections and bring a different

perspective to the inspection process. Name of Specialist (e.g.

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INTRODUCTION TO REPORT AND INSPECTION

Independent and local authority fostering services which fall within the jurisdiction of the Commission for Social Care Inspection (CSCI) are subject to inspection, to establish if the service is meeting the National Minimum Standards for Fostering Services and the requirements of the Care Standards Act 2000, the Fostering Services Regulations 2002 and the Children Act 1989 as amended.

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INTRODUCTION TO REPORT AND INSPECTION

This document summarises the inspection findings of the CSCI in respect of Cares (NFP) Ltd T/A Foster Cares. The inspection findings relate to the National Minimum Standards for Fostering Services published by the Secretary of State under sections 23 and 49 of the Care Standards Act 2000, for independent and local authority fostering services respectively.

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INTRODUCTION TO REPORT AND INSPECTION

The Fostering Services Regulations 2002 are secondary legislation, with which a service provider must comply. Service providers are expected to comply fully with the National Minimum Standards. The National Minimum standards will form the basis for judgements by the CSCI in relation to independent fostering agencies regarding registration, the imposition and variation of registration conditions and any enforcement action, and in relation to local authority fostering services regarding notices to the local authority and reports to the Secretary of State under section 47 of the Care Standards Act 2000. The report follows the format of the National Minimum Standards and the numbering shown in the report corresponds to that of the standards.

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INTRODUCTION TO REPORT AND INSPECTION

The report will show the following: • Inspection methods used • Key findings and evidence • Overall ratings in relation to the standards • Compliance with the Regulations • Notifications to the Local Authority and Reports to the Secretary of State • Required actions on the part of the provider • Recommended good practice • Summary of the findings • Report of the Lay Assessor (where relevant) • Providers response and proposed action plan to address findings

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INSPECTION VISITS

Inspections will be undertaken in line with the agreed regulatory framework with additional visits as required. This is in accordance with the provisions of the Care Standards Act 2000. The following inspection methods have been used in the production of this report. The report represents the inspector's findings from the evidence found at the specified inspection dates. Cares (NFP) Ltd T/A Foster Cares Page 5 BRIEF DESCRIPTION OF THE SERVICES PROVIDED. The Cares (NFP) Ltd Fostering agency, trading as FOSTER CARES provides foster care services within the North East Durham, Darlington and surrounding regions. This fostering service is now 4 years old.

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INSPECTION VISITS

At the time of the inspection the agency employed five social workers, three administration workers and the director is also the registered manager. The responsible individual is David Cassie.

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INSPECTION VISITS

This not for profit service provides foster care services for children with a broad range of needs and placements are available on a long term, short term, task centred, remand, emergency and respite basis.

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INSPECTION VISITS

The statement of purpose states that there are 29 sets of foster carers providing 29 placements for children. Cares (NFP) Ltd T/A Foster Cares Page 6

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Inspector’s Summary

(This is an overview of the inspector’s findings, which includes good practice, quality issues, areas to be addressed or developed and any other concerns.) This is the third inspection of Foster Cares since the introduction of National Minimum Standards (NMS) and the Fostering Services Regulations 2002. Since that time it has become a requirement that all independent fostering agencies be registered and inspected once a year. The information contained within this report is a summary of the inspection findings; fuller reporting about standard areas is contained within the main body of the report. The findings were as follows.

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Inspector’s Summary

Statement of Purpose Standard 1. This standard was fully met at the time of the last inspection; the Children’s guide has been updated as previously recommended to include information about health care arrangements. This standard is therefore exceeded.

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Inspector’s Summary

Fitness to provide or manage a fostering service Standards 2 and 3. Consultation with staff, carers, children, young people and questionnaires from placing authorities confirms that leadership and management of the agency is effective. Recruitment files evidenced that Disqualification from Caring for Children Regulations (DCCR) were being applied, all staff were required to sign up to the agency confidentiality policy. There was evidence of good practice with three references being taken up in the majority of cases. Standard 2 is fully met and 3 is exceeded.

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Inspector’s Summary

Management of the fostering service Standards 4 and 5. There are systems in place so that young people views are elicited about the service they receive, for example by end of placement reports. The inspector was also given to understand that social work students have undertaken additional consultation with children/young people. A job description and person specification is in place for the registered manager. Since the time of the last inspection a previous recommendation has now been actioned by amendment to the job description for the senior link social worker. Standard 4 is exceeded and 5 is fully met.

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Inspector’s Summary

Securing and promoting welfare Standards 6,7,8,9,10,11,12,13, 14. The majority of carers consulted spoke knowledgeably about issues of risk and management. However there was no evidence of written risk assessments being in place. The agency operates a non-discriminatory approach with regards to caring for children from diverse backgrounds. A document called “Responsibilities of the Placing Authority” makes clear what the agency requires of them. Approval status of carers is considered again at the time of reviews. Team meetings are the principle forum in which matching is discussed. Carers consulted had completed Child Protection and Safe Caring training, they demonstrated a good understanding of the agency policy and procedures concerning disciplinary measures. Children and young people were well supported by carers pro- Cares (NFP) Ltd T/A Foster Cares Page 7 actively assisting them in maintaining contact. They also considered themselves able to

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Inspector’s Summary

make choices within reason about all matters affecting them on day-to-day basis. Health care needs of children and young people are raised within foster carers supervision. Scrutiny of children and young peoples files concludes that health care records were not in place. Education was appropriately supported and encouraged by foster carers and in addition to this children and young people were enabled to participate in a range of extra curricular activities. A brief basic procedure has been written “ Preparing for Independence” this is a helpful document which provides some direction to young people and foster carers about a timetable designed to enable foster carers to develop skills of daily living. Standards 6,7,9,12,13,14 are fully met, standards 8,10,11 are exceeded.

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Recruiting, checking, managing, supporting and training staff and foster carers

Standards 15,16,17,18,19,20,21,22,23. A nominated individual within human resources is responsible for signing off recruitment files and significant improvements have been made in this area. In addition to the registered manager the agency employs five social workers an administration supervisor and two additional administrators. There is a stable staff team in place and agency workers are not used. Review material in respect of carers has been updated in compliance with requirements made at the time of the previous inspection. A consultation group to further develop services is in place and this is chaired by a non-executive board member who then feedbacks to the agency. The registered manager is a mentor for the Post- Qualifying (PQ) award in childcare for social workers and there were plans in place for this to be completed by a worker. As part of the inspection process a team meeting was observed and this

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Recruiting, checking, managing, supporting and training staff and foster carers

provides an additional regular forum in which any matters regarding the needs of children and young people placed can be tracked and monitored. The preparation training has been re-titled “Skills to Foster” and ideally this training would be provided to applicants prior to commencement of the assessment process of prospective foster carers. Sources of assistance and counselling have been identified by the agency in the event that foster carers required this type of assistance. Training is evaluated on a sessional basis and the annual review of foster carers also takes attendance at training into account. Standards 15,18,19,20,21,22,23 are fully met and standards16,17 are exceeded.

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Recruiting, checking, managing, supporting and training staff and foster carers

Record Standard 24,25. Scrutiny of children’s records revealed some variance with regards to information supplied by placing authorities. Recruitment files relating to staff contained all of the information as required by The Fostering Services Regulations 2002 Schedule 2. Standards 24 and 24 are fully met.

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Recruiting, checking, managing, supporting and training staff and foster carers

Fitness of premises for use as fostering service Standard 26. The building continues to be used for all training purposes and there is adequate space in order for panel meetings to take place. Security measures remain to a high standard, the building is accessible to wheelchair users. Standard 26 is exceeded.

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Recruiting, checking, managing, supporting and training staff and foster carers

Financial requirements Standards 27,28,29.

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Recruiting, checking, managing, supporting and training staff and foster carers

The registered manager has full budgetary control and regular liaison with agency accountants was reported to take place. Consideration to the budget for Foster Cares is undertaken on a weekly basis. The agency directors continue to have regular financial meetings and financial reports are also compiled. An accountant is used to carry out regular external audits. Financial polices and procedures are clearly outlined within the Foster Carers Handbook. All standards within this area are fully met. Cares (NFP) Ltd T/A Foster Cares Page 8 Fostering Panels Standard 30. The registered manager reported improvements with regards to recruitment of panel members. Two written references for each panel member are taken up. A young person has also been appointed to panel. This standard is fully met.

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Recruiting, checking, managing, supporting and training staff and foster carers

Short-term breaks Standard 31. The agency does not offer a specific short- term break service, however respite care is afforded to carers. Where this takes place this is by means of an identified approved carer with the Cares Agency. This standard is fully met.

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Recruiting, checking, managing, supporting and training staff and foster carers

Family and friends as carers Standard 32. Not applicable. Cares (NFP) Ltd T/A Foster Cares Page 9

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(Local Authority Fostering Services Only)

The following statutory Reports or Notifications are to be made under the Care Standards Act as a result of the findings of this inspection:

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(Local Authority Fostering Services Only)

NO Report to the Secretary of State under section 47(3) of the Care Standards Act 2000 that the Commission considers the Local Authority's fostering service satisfies the regulatory requirements:

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(Local Authority Fostering Services Only)

NO Notice to the Local Authority under section 47(5) of the Care Standards Act 2000 of failure(s) to satisfy regulatory requirements in their fostering service which are not substantial, and specifying the action the Commission considers the Authority should take to remedy the failure(s), informing the Secretary of State of that Notice: NO Report to the Secretary of State under section 47(4)(a) of the Care Standards Act of a failure by a Local Authority fostering service to satisfy regulatory requirements which is not considered substantial:

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(Local Authority Fostering Services Only)

NO Report to the Secretary of State under section 47(1) of the Care Standards Act 2000 of substantial failure to satisfy regulatory requirements by a Local Authority fostering service:

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The grounds for the above Report or Notice are:

Cares (NFP) Ltd T/A Foster Cares Page 10

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Implementation of Statutory Requirements from Last Inspection

Requirements from last Inspection visit fully actioned? NO

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STATUTORY REQUIREMENTS

Identified below are areas not addressed from the last inspection report which indicate a non-compliance with the Care Standards Act 2000 and Fostering Services Regulations 2002. No. Regulation Standard Required actions Timescale for action 1 21 (2) (b) FS2FS2F S15FS15 The registered person must ensure that the disciplinary policy be brought up to standard to include the requirement that failure to report and incident of abuse is a disciplinary matter. 30/3/2005

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STATUTORY REQUIREMENTS

2 11 (a) FS20FS2 The registered manager must ensure that risk assessments are compiled and in place for all children and young people and robust efforts should be made by agency social workers to obtain risk assessments from placing authorities as part of the referral process. Where risk assessments are undertaken by the agency these must be done in conjunction with the placing authority. 31/3/2005

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STATUTORY REQUIREMENTS

3 28 (5) (b) FS22FS2 The registered person must ensure that the Foster Carers Agreement make explicit that foster carers have to comply with the terms of any foster placement agreement and also make explicit that they must allow any child placed with them to be removed from the foster carers home if regulation 36 applies. 31/3/2005

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STATUTORY REQUIREMENTS

4 18 (2) (b) (c) FS22FS2 The registered person must ensure that the agencies complaints procedures make explicit that no person who is the subject of a complaint takes part in its consideration other than if the registered person considers it appropriate, at the informal resolution stage only. The procedure must also make provision for dealing with complaints about the registered person. 31/3/2005 Cares (NFP) Ltd T/A Foster Cares Page 11

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Action is being taken by the Commission for Social Care Inspection to monitor

compliance with the above requirements. Cares (NFP) Ltd T/A Foster Cares Page 12

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registration are listed below, with the inspector's assessment of compliance from

the evidence at the time of this inspection.

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Date 22 November 2004

Cares (NFP) Ltd T/A Foster Cares Page 13

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STATUTORY REQUIREMENTS IDENTIFIED DURING THIS INSPECTION

Action Plan: The appropriate Officer of the Local Authority or the Registered Person (as applicable) is requested to provide the Commission with an Action Plan, which indicates how requirements are to be addressed. This action plan will be made available on request to the Area Office.

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STATUTORY REQUIREMENTS

Identified below are areas addressed in the main body of the report which indicate non- compliance with the Care Standards Act 2000, the Children Act 1989, the Fostering Services Regulations 2002, or the National Minimum Standards for Fostering Services. The Authority or Registered Person(s) is/are required to comply within the given time scales in order to comply with the Regulatory Requirements for fostering services. No. Regulation Standard * Requirement Timescale for action

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STATUTORY REQUIREMENTS

1 11 FS11FS11 The registered person must ensure that risk assessments are completed for all children and young people placed and that all carers are made fully aware of risk assessments and their responsibilities as carers in this regard. 30/3/2005

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STATUTORY REQUIREMENTS

2 25 (2) FS30FS30 The registered person must ensure that panel minutes always make clear the reasons recommendations made. 30/3/2005

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STATUTORY REQUIREMENTS

Schedule 2 FS25FS25 The registered person must ensure that the register in respect of each child be maintained up to date. 30/3/2005

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

Identified below are areas addressed in the main body of the report which relate to the National Minimum Standards and are seen as good practice issues which should be considered for implementation by the Authority or Registered Person(s). No. Refer to Standard * Recommendation Action

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

1 FS3FS3 It is recommended that the registered manager achieve a management qualification in line with NMS by the end of 2005.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

2 FS6FS6 The registered person should ensure that all children and young people are informed about external agencies with whom they could raise a concern if appropriate. Cares (NFP) Ltd T/A Foster Cares Page 14 3 FS9FS9 The registered person should ensure that guidance for foster carers and appropriate others also contain specific information relating to any methods of physical intervention recommended by the agency.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

4 FS12FS12 The registered person should ensure that where carers smoke all possible measures are taken to ensure that any possible ill effects for the child are prevented. Any such measures should be taken into account within reviews of foster carers. It is also recommended that health care plans be completed for children and young people as soon as possible after admission, if they are not received from the placing authority. This needs to be completed in liaison with the identified social worker by the validation of such documentation.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

5 FS13FS13 The registered person should ensure that systems currently in place to monitor the educational attainments of children and young people are commensurate with any further expansion of the agency.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

6 FS14FS14 The registered person should ensure that the preparing for independence policies and procedures are further developed, with consideration being given to providing specific training for foster carers about independent living.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

7 FS30FS30 The registered person should ensure that panel procedures include guidance about decision making when all members of panel are not in agreement.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

8 FS28FS28 The registered person should ensure that financial procedures also taken into account the steps to be taken in situations of financial crisis as outlined within 27.2 of NMS.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

9 FS25FS25 The registered person should ensure that consistent record keeping be maintained with regards to foster carers files and diary information. It is strongly recommended that link workers should sign off entries in diaries by foster carers during the course of supervision.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

10 FS24FS24 The registered person should ensure that increased efforts are made to so that a consistent quality of fully completed LAC documentation is supplied to the agency.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

11 FS18FS18 The registered person should ensure that the on call policy is reviewed to ensure that the current system meets the needs of the service. Also the area of standard 18 concerning insurance cover be kept under review and progressed where possible.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

12 FS21FS21 The registered person should ensure that the means by which encouragement is given to carers regarding self-help groups be included within the Foster Carers Handbook.

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GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION

13 FS30FS30 The registered person should ensure that the circumstances in which a foster carer would be deregistered be outlined within procedural guidance. Cares (NFP) Ltd T/A Foster Cares Page 15 * Note: You may refer to the relevant standard in the remainder of the report by omitting the 2-letter prefix e.g FS10 refers to Standard 10.

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PART B INSPECTION METHODS & FINDINGS

The following inspection methods have been used in the production of this report Number of Inspector days spent 4

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PART B INSPECTION METHODS & FINDINGS

Survey of placing authorities YES Foster carer survey YES Foster children survey YES Checks with other organisations and Individuals YES • Directors of Social services NO • Child protection officer NO • Specialist advisor (s) NO • Local Foster Care Association NO Tracking Individual welfare arrangements YES • Interview with children YES • Interview with foster carers YES • Interview with agency staff YES • Contact with parents NO • Contact with supervising social workers YES • Examination of files YES Individual interview with manager YES Information from provider YES Individual interviews with key staff YES Group discussion with staff NO Interview with panel chair NO Observation of foster carer training NO Observation of foster panel NO Inspection of policy/practice documents YES Inspection of records YES Interview with individual child YES

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PART B INSPECTION METHODS & FINDINGS

Date of Inspection 22/11/2004 Time of Inspection 9.30 Duration Of Inspection (hrs) 30 Cares (NFP) Ltd T/A Foster Cares Page 16 The following pages summarise the key findings and evidence from this inspection, together with the CSCI assessment of the extent to which the National Minimum 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?"

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PART B INSPECTION METHODS & FINDINGS

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)

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PART B INSPECTION METHODS & FINDINGS

"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. Cares (NFP) Ltd T/A Foster Cares Page 17

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The intended outcome for the following standard is:

• There is clear statement of the aims and objectives of the fostering service and the fostering service ensures that they meet those aims and objectives.

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There is a clear statement of the aims and objectives of the fostering service and of

what facilities and services they provide. Key Findings and Evidence Standard met? 4 This standard was fully met at the time of the last inspection, since that time the Children’s guide has been updated as recommended at that time to include information about health care arrangements. Both the statement of purpose and the aforementioned guide are good quality documents, which are comprehensive and user friendly. Consultation with the registered manager confirms that if the need arises the children’s guide could be made available in a variety of different forms. Systems are in place so that the statement of purpose can be reviewed by the responsible individual. Cares (NFP) Ltd T/A Foster Cares Page 18

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The intended outcomes for the following set of standards are:

• The fostering service is provided and managed by those with the appropriate

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work efficiently and effectively and have the necessary knowledge and experience of

childcare and fostering to do so in a professional manner. Key Findings and Evidence Standard met? 3 This standard was fully met at the time of the last inspection, at that time a recommendation was made that the registered manager commences training in order to obtain a management qualification by 2005. Consultation with the registered manager confirmed that plans were in place to commence such training in January 2005. Consultation with staff, carers, children, young people and questionnaires from placing authorities confirms that leadership and management of the agency is effective. Organised and consistent management arrangements were also clearly evident throughout the course of the inspection process.

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Any persons carrying on or managing the fostering service are suitable people to run

a business concerned with safeguarding and promoting the welfare of children. Key Findings and Evidence Standard met? 4 This standard was almost met at the time of the last inspection; requirements and recommendations made at that time have since been met. All personal files examined were found to comply with the regulatory requirement with one exception. A discrepancy was identified relating to a CRB, which was raised with the registered manager, and this was being appropriately addressed. The agency accepts social work students for placement and it was evident that careful recruitment procedures were also undertaken in enabling students to work at the agency. Recruitment files evidenced that DCCR Regulations were being applied, all staff were required to sign up to the agency confidentiality policy and there evidence of good practice with three references being taken up in the majority of cases. The

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Any persons carrying on or managing the fostering service are suitable people to run

standard is therefore exceeded. Cares (NFP) Ltd T/A Foster Cares Page 19

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The intended outcomes for the following set of standards are:

• The fostering service is managed ethically and efficiently, delivering a good quality foster care service and avoiding confusion and conflicts of role.

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There are clear procedures for monitoring and controlling the activities of the

fostering service and ensuring quality performance. Key Findings and Evidence Standard met? 4 This standard was fully met at the time of the last inspection. The registered manager continues to undertake Regulation 42 monitoring. There are systems in place so that young people views are elicited about the service they receive, for example by end of placement reports. The inspector was also given to understand that social work students have undertaken additional consultation with children/young. Unannounced visits to foster carers were reported to take place on a six monthly basis. Meetings between the responsible individual and the registered manager continue to take place on a regular basis. A whistle blowing policy is in place and this makes clear that failure to report and incidence of abuse is regarded as a serious matter and grounds for disciplinary proceedings to be implemented. Agreement was reached with the registered manager that copies of Regulation 42 reports

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There are clear procedures for monitoring and controlling the activities of the

would be forwarded to the CSCI on a monthly basis.

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There are clear procedures for monitoring and controlling the activities of the

Number of statutory notifications made to CSCI in last 12 months: 0

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There are clear procedures for monitoring and controlling the activities of the

Death of a child placed with foster parents. 0

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Referral to Secretary of State of a person working for the service as

unsuitable to work with children. Serious illness or accident of a child. 0 Outbreak of serious infectious disease at a foster home. 0 Actual or suspected involvement of a child in prostitution. 0

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Serious incident relating to a foster child involving calling the police to a

foster home. Serious complaint about a foster parent. 0 Initiation of child protection enquiry involving a child. 1

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Serious incident relating to a foster child involving calling the police to a

Number of complaints made to CSCI about the agency in the past 12 months: 0 Number of the above complaints which were substantiated: 0 Cares (NFP) Ltd T/A Foster Cares Page 20

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Standard 5 (5.1 - 5.4)

The fostering service is managed effectively and efficiently. Key Findings and Evidence Standard met? 3 This standard was fully met at the time of the last inspection. As previously indicated there was firm evidence, which demonstrates the agency is managed effectively and efficiently. A job description and person specification is in place for the registered manager. Since the time of the last inspection the recommendation made at that time has now been actioned by amendment to the job description for the senior link social worker. The person undertaking this role is required “To deputise for the Director of Foster Cares during periods of absence as required and agreed by the chief Executive of the Cares Group”. Cares (NFP) Ltd T/A Foster Cares Page 21

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The intended outcome for the following set of standards is:

• The fostering service promotes and safeguards the child/young person's physical, mental and emotional welfare.

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The fostering service makes available foster carers who provide a safe, healthy and

nurturing environment. Key Findings and Evidence Standard met? 3 This standard was fully met at the time of the last inspection. Four carers were visited as part of the inspection and it was evident that carers recruited by the agency are able to provide clean, comfortable, homely and well-decorated accommodation. Carers consulted confirmed their attendance at training provided by the agency and each carer had a training portfolio. Out of hours support was described as very good. The majority of carers consulted spoke knowledgeably about issues of risk and management. However there was no evidence of written risk assessments being in place. The registered manager and consultation with staff confirms that as yet these are not in place for all children/young people so this is still an area for further development. Inspection of documentation held by carers found that the necessary records were in place and well ordered. Children and young people consulted

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The fostering service makes available foster carers who provide a safe, healthy and

were aware of how to raise a complaint within the agency, however they were less aware of access to external agencies with any concerns if appropriate, for example CSCI.

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The fostering service makes available foster carers who provide a safe, healthy and

The registered person must ensure that risk assessments are completed for all children and young people placed and that all carers are made fully aware of risk assessments and their responsibilities as carers in this regard. See requirement 1.

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The fostering service makes available foster carers who provide a safe, healthy and

The registered person should ensure that all children and young people are informed about external agencies with whom they could raise a concern if appropriate. See recommendation 2.

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The fostering service ensures that children and young people, and their families, are

provided with foster care services which value diversity and promote equality. Key Findings and Evidence Standard met? 3 This standard was almost met at when the agency was last inspected. At that time it was identified that agency carers were looking after a minority group of children and young people from a number of different cultural backgrounds. These placements were continuing at the time of this inspection. The agency operates a non-discriminatory approach with regards to caring for children from diverse backgrounds. A black male independent visitor continues to offer support to a child. Consultation with the registered manager and staff of the agency concludes that careful consideration is given as to whether or not the cultural needs of a child could be met at the time of the referral. Cares (NFP) Ltd T/A Foster Cares Page 22

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carers only if they represent appropriate matches for a child for whom a local

authority is seeking a carer. Key Findings and Evidence Standard met? 4 This standard was almost met when the agency was last inspected. Requirements made at that time have been addressed. A “Referral Form”, “Initial Risk Assessment” and “Young Persons Risk Assessment” proforma’s have been developed. Risk assessment is also taken into account within the “Initial Referral Information Match Identified” proforma. Consultation with the registered manager and staff concludes that more referrals have been made for planned placements than on an emergency basis. A document called “Responsibilities of the Placing Authority” makes clear what the agency requires of them. Approval status of carers is considered again at the time of reviews. Team meetings are the principle forum in which matching is discussed. The policy and procedure concerning matching makes clear the need to carry out a risk assessment as a part of this process. Consultation with carers, children,

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carers only if they represent appropriate matches for a child for whom a local

young people and staff concludes that matching is considered very carefully.

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The fostering service protects each child or young person from all forms of abuse,

neglect, exploitation and deprivation. Key Findings and Evidence Standard met? 3 This standard was previously fully met when last inspected. Carers consulted had completed Child Protection and Safe Caring training, they demonstrated a good understanding of the agency policy and procedures concerning disciplinary measures. Questionnaires and interviews with children and young people indicated the view that any sanctions used were fair and appropriate. A policy regarding physical interventions by foster carers is in place and this outlines that any such intervention should be used only as a last resort. Carers receive Team Teach training. Methodologies should be included within this policy for the guidance of carers and appropriate others. Child protection guidance is contained within the Foster Carer Handbook and referenced for ease of access. The statement of purpose includes the address and telephone of the CSCI. The “Children and Young people’s Handbook and

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The fostering service protects each child or young person from all forms of abuse,

Guidance” also includes details of how to contact CSCI, as well as a range of children’s protection and advocacy services. However as previously indicated there was anecdotal evidence, which indicated that children and young people were not as aware of this information as would be considered reasonable and in their best interests. To this end a good practice recommendation has been made within the appropriate section of this report.

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The fostering service protects each child or young person from all forms of abuse,

The registered person should ensure that guidance for foster carers and appropriate others also contain specific information relating to any methods of physical intervention recommended by the agency. See recommendation 3.

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being bullied:

100 % Cares (NFP) Ltd T/A Foster Cares Page 23

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encouraged to maintain and develop family contacts and friendships as set out in

her/his care plan and/or foster placement agreement. Key Findings and Evidence Standard met? 4 This standard was fully met at the time of the last inspection. Consultation with the carers demonstrated that this continues to be the case. Children and young people were well supported by carers pro-actively assisting them in maintaining contact. Carers facilitated visits, helped children and young people with contact by post and it was also evident that some challenging situations arising because of contact issues had been well managed by carers and the agency. Link workers confirmed that the importance and significance of contact for children and young people is a live theme, which is constantly stressed to carers through preparation, ongoing training and at supervision.

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others significant to the child, are sought over all issues that are likely to affect their

daily life and their future. Key Findings and Evidence Standard met? 4 This standard was exceeded at the time of the last inspection. The additional good practice in evidence at the time of the last inspection continues. This has been built upon further, with foster carers own children engaging more in support services provided to them by the agency. Children and young peoples views are gathered about the service they receive and as part of the review process. All children and young people consulted during the inspection felt that they were well supported they also considered themselves able to make choices within reason about all matters affecting them on day-to-day basis. Questionnaires completed by children, young people, foster carers and placing authorities all expressed a high level of satisfaction with the service. However a comment was also made about the impact for children and young people when foster carers smoke.

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training appropriate to her/his age and understanding to enable informed participation

in decisions about her/his health needs. Key Findings and Evidence Standard met? 3 This standard was fully met at the time of the last inspection. The plans of the agency have now changed and a decision has been made not to provide in house counselling provision for children and young people. However further work has been carried out with regards to ensuring that procedures and policy are in place so that children and young people in need can be appropriately referred to CAMHS (Child and Adolescent Psychiatry Services). A draft pilot protocol was in place, which made clear the joint working necessary in order to facilitate such referrals. A referral form to be completed by the appointed social worker was also evidenced.

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training appropriate to her/his age and understanding to enable informed participation

The document “Responsibilities of the Placing Authority” makes clear that it is of “vital importance” that authorities forward information concerning health needs to the agency. Health care needs of children and young people are raised within foster carers supervision. Cares (NFP) Ltd T/A Foster Cares Page 24 Scrutiny of children and young peoples files concludes that health care records were not in place. Consultation with children, young people and foster carers confirms that all appropriate support and access to services is secured.

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training appropriate to her/his age and understanding to enable informed participation

The registered person should ensure that health care plans be completed for children and young people as soon as possible after admission, if they are not received from the placing authority. This needs to be completed in liaison with the identified social worker by the validation of such documentation. See recommendation 4.

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training appropriate to her/his age and understanding to enable informed participation

The registered person should ensure that where foster carers smoke all possible measures are taken to ensure that any possible ill effects for the child are prevented. Smoking patterns of carers and any measures used should be taken into account within reviews of foster carers. See recommendation 4.

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child or young person in foster care and ensures that she/he is encouraged to attain

her/his full potential. Key Findings and Evidence Standard met? 3 At the time of the last inspection this standard was fully met. At the time of the inspection the majority of young people were attending mainstream education. The availability of school placements for children and young people were described as having greatly improved since the time of the last inspection. Contact had been made with the Connexions service and this was experienced as providing a valuable service to the children, young people and foster carers. Educational achievements of young people were monitored within team meetings and written records were kept. Education was appropriately supported and encouraged by foster carers and in addition to this children and young people were enabled to participate in a range of extra curricular activities. Questionnaires completed by children and young people also indicated that education was viewed as a high priority by agency foster carers.

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child or young person in foster care and ensures that she/he is encouraged to attain

The registered person should ensure that systems currently in place to monitor the educational attainments of children and young people are commensurate with any further expansion of the agency. See recommendation 5.

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The fostering service ensures that their foster care services help to develop skills,

competence and knowledge necessary for adult living. Key Findings and Evidence Standard met? 3 This standard was fully met at the time of the last inspection. A brief basic procedure has been written “ Preparing for Independence” this is a helpful document which provides some direction to young people and foster carers about a timetable designed to enable foster carers to develop skills of daily living. It was pleasing to note that financial assistance is provided by the agency to enable budget skills. As previously referred to the service’s of Connexions are also used. The registered person should ensure that the preparing for independence policies and procedures are further developed with consideration being given to providing specific training for foster carers about independent living. See recommendation 6. Cares (NFP) Ltd T/A Foster Cares Page 25

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The intended outcome for the following set of standards is:

• The people who work in or for the fostering service are suitable to work with

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number of staff and carers and their range of qualifications and experience are

sufficient to achieve the purposes and functions of the organisation.

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Any people working in or for the fostering service are suitable people to work with

children and young people and to safeguard and promote their welfare. Key Findings and Evidence Standard met? 3 This standard was almost met at the time of the last inspection. All but one of the requirements made at that time have since been met, see Standard 3 for fuller reporting of matters in this regard. A nominated individual within human resources is responsible for signing off recruitment files and as previously indicated significant improvements have been made in this area. Staff are made aware of their responsibility to report any incidence of abuse of a child placed with foster carers.

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Any people working in or for the fostering service are suitable people to work with

The registered person must ensure that staff disciplinary procedures make clear that the failure on the part of an employee to report an incidence of abuse of a child placed with foster carers to an appropriate person is grounds on which disciplinary proceedings may be instituted. See Statutory Requirement 1 from last inspection.

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Staff are organised and managed in a way that delivers an efficient and effective

foster care service. Key Findings and Evidence Standard met? 4 This standard was exceeded at the time of the last inspection. In addition to the registered manager the agency employs five social workers an administration supervisor and two additional administrators. Examination of documentary evidence, consultation with staff, carers and children confirms that the organisation and management of the agency, since the time of the last inspection has continued to be maintained at a level, which exceeds this standard. Cares (NFP) Ltd T/A Foster Cares Page 26

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qualified staff and recruits a range of carers to meet the needs of children and young

people for whom it aims to provide a service. Key Findings and Evidence Standard met? 4 This standard was met at the time of the last inspection. Since the time of the last inspection a further two staff have been appointed. Staff details are outlined within the agency statement of purpose which reads that all supervising social workers are qualified and experienced practioners in “childcare practice, policy and legislation”. There is a stable staff team in place and agency workers are not used. Review material in respect of carers has been updated in compliance with requirements made at the time of the previous inspection. The registered manager stated that the agency was moving towards a more competency based assessment and review process, so that achievements by foster carers could be measured as part of the review process. Where appropriate foster carers own children are invited to attend “Skills to Foster”. All reviews go to panel and carers are also invited so that

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qualified staff and recruits a range of carers to meet the needs of children and young

panel can provide a further quality assurance role in assessing that carers have received sufficient support, training or whatever was agreed with them by the agency. The standard is therefore exceeded.

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The fostering service is a fair and competent employer, with sound employment

practices and good support for its staff and carers. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. The agency still operates a duty system, which includes access to a manager and the responsible individual if necessary. A twenty-four hour call centre is used to screen and respond to calls. Management systems are in place for carer supervision and support. A consultation group to further develop services is in place this is chaired by a non-executive board member who then feedbacks to the registered manager. The recommendation made at the time of the last inspection to review the on-call policy has not yet been actioned. Public liability insurance remains in place however it appears that this cover does not extend to all aspects covered by the standard. This area needs to be kept under review and if possible, to be progressed.

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The fostering service is a fair and competent employer, with sound employment

The registered person should ensure that the on call policy is reviewed to ensure that the current system meets the needs of the service. Also the area of standard 18 concerning insurance cover be kept under review and progressed where possible. See recommendation 18. Cares (NFP) Ltd T/A Foster Cares Page 27

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There is a good quality training programme to enhance individual skills and to keep

staff up-to-date with professional and legal developments. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. A policy is in place for supervision and appraisal of staff. Joint training takes place between staff and foster carers. The registered manager is a mentor for the Post- Qualifying (PQ) award in childcare for social workers and there were plans in place for this to be completed by a worker. There was an expectation that all the agencies social workers will sign up to complete the PQ award. The registered manager stated that continuing professional development for social workers is proactively promoted. It was evident that there were opportunities for staff to undertake various post-qualifying training and any identified targets in this area were monitored as part of supervision and appraisal. Since the time of the last inspection all staff have received

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Standard 20 (20.1 - 20.5)

All staff are properly accountable and supported. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. All social work staff were interviewed during the inspection process, it was evident that staff are accountable and properly supported, in addition to staff receiving monthly supervision. The registered manager operates an open door policy and all staff reported being able to access managerial supervision when needed. As part of the inspection process a team meeting was observed and this provides an additional regular forum in which any matters regarding the needs of children and young people placed can be tracked and monitored. Team meeting take place regularly and are recorded. It was evident that some policies and procedures had been updated as necessary. At the time of the last inspection risk assessments were required to be in place on all children/young people placed. This work was still being

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Standard 20 (20.1 - 20.5)

progressed at the time of the inspection. Tracking and visits to carers revealed that there was varying levels of understanding amongst carers regarding risk and risk assessment.

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Standard 20 (20.1 - 20.5)

The registered manager must ensure that risk assessments are compiled and in place for all children and young people and robust efforts should be made by agency social workers to obtain risk assessments from placing authorities as part of the referral process. Where risk assessments are undertaken by the agency these must be done in conjunction with the placing authority. See requirement 3 of Statutory Requirements still outstanding from the last inspection. Cares (NFP) Ltd T/A Foster Cares Page 28

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Standard 21 (21.1 - 21.6)

The fostering service has a clear strategy for working with and supporting carers. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. The preparation training has been re-titled “Skills to Foster” and ideally this training would be provided to applicants prior to commencement of the assessment process of prospective foster carers. Such training was reported to take place on an approximately quarterly basis. The statement of purpose and the Foster Carers Handbook includes the majority of information as listed by 21.1 of NMS regarding a clear strategy for working with carers. However the arrangements for encouraging carers regarding self-help groups were not evident within either of these documents

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Standard 21 (21.1 - 21.6)

The registered person should ensure that the means by which encouragement is given to carers regarding self-help groups be included within the Foster Carers Handbook. See recommendation 12.

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The fostering service is a managed one that provides supervision for foster carers

and helps them to develop their skills. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. Examination of foster carers files confirms that supervision visits take place and sessions are recorded, there was some variance regarding the frequency of visits. Tracking and foster carers questionnaires confirms that guidance and development of foster carers skills is appropriate. Sources of assistance and counselling have been identified by the agency in the event that foster carers required this type of assistance. A sample copy of the Foster Care Agreement document as contained within updated Foster Carers handbook was checked for regulatory compliance.

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The fostering service is a managed one that provides supervision for foster carers

The registered person must ensure that the aforementioned document makes explicit that foster carers have to comply with the terms of any Foster Placement Agreement and also that they must allow any child placed with them to be removed from the foster carers home if regulation 36 applies. Complaints procedures must make explicit that no person who is the subject of a complaint takes part in its consideration other than if the registered person considers it appropriate, at the informal resolution stage only. The procedure must also make provision for dealing with complaints about the registered person. See 4 and 5 of Statutory Requirement still outstanding from the last inspection.

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The fostering service is a managed one that provides supervision for foster carers

The circumstances in which a foster carer would be deregistered should be made outlined within procedural guidance. See recommendation 13. Cares (NFP) Ltd T/A Foster Cares Page 29

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provide high quality care and meet the needs of each child/young person placed in

their care. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. Consultation with foster carers, staff and documentary evidence confirms that good quality training is available. Training is evaluated on a sessional basis and the annual review of foster carers also takes attendance at training into account. Skills to Foster training is completed by prospective foster carers. The agency seeks to be flexible as to the timing of training events so as to maximise attendance. A training programme is in place, which includes “Core Training” and “Optional Training”. Cares (NFP) Ltd T/A Foster Cares Page 30

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The intended outcome for the following set of standards is:

• All appropriate records are kept and are accessible in relation to the fostering services and the individual foster carers and foster children.

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maintained for each child or young person in foster care which details the nature and

quality of care provided and contributes to an understanding of her/his life events.

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Relevant information from the case records is made available to the child and to

anyone involved in her/his care. Key Findings and Evidence Standard met? 3 This standard was almost met at the time of the last inspection. Scrutiny of children’s records revealed some variance with regards to information supplied by placing authorities. The agency must continue to be vigilant in ensuring that all required information is obtained and strenuous efforts should be made to obtain the necessary information at the time of the initial referral.

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Relevant information from the case records is made available to the child and to

It was pleasing to note that the agency have a Placement Plan proforma to be used at the time of a placement meeting in the event such documents are not provided by the responsible authority.

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Relevant information from the case records is made available to the child and to

The registered person should ensure that increased efforts are made to ensure a consistent quality of fully completed LAC documentation is supplied to the agency. See recommendation 10.

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The fostering service's administrative records contain all significant information

relevant to the running of the foster care service and as required by regulations. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. Recommendations made at that time have been progressed. Recruitment files relating to staff contained all of the information as required by The Fostering Services Regulations 2002 Schedule 2. A register of foster carers and children is kept however there were gaps within these documents. Systems are in place so that records can be readily passed on should the need arise. Agency files of foster carer’s appeared well ordered, there was evidence that link workers viewed carers diaries. In some instances diary records were copied and placed on file, consistent practice should be achieved in this regard. Records of complaints, accidents and allegations are maintained by the agency. The agency requires foster carers to have locked boxes in which

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The fostering service's administrative records contain all significant information

The registered person must ensure that the register in respect of each child be maintained up to date. See requirement 3.

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The fostering service's administrative records contain all significant information

The registered person should ensure that consistent record keeping is maintained with regards to foster carers files and diary information. It is strongly recommended that link Cares (NFP) Ltd T/A Foster Cares Page 31 workers should sign off entries in diaries by foster carers during the course of supervision. See recommendation 9.

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The fostering service's administrative records contain all significant information

Number of current foster placements supported by the agency: 27 Number of placements made by the agency in the last 12 months: X

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months:

X Number of new foster carers approved during the last 12 months: X Number of foster carers who left the agency during the last 12 months: X

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Maximum £

Cares (NFP) Ltd T/A Foster Cares Page 32

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The intended outcome for the following standard is:

• The premises used as offices by the fostering service are suitable for the purpose.

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Standard 26 (26.1 - 26.5)

Premises used as offices by the fostering service are appropriate for the purpose. Key Findings and Evidence Standard met? 4 This standard was exceeded at the time of the last inspection. The only recommendation made at that time concerned ensuring that staff working solely for Foster Cares be separated from other staff for reasons of confidentiality and this has subsequently been implemented. The building continues to be used for all training purposes and there is adequate space in order for panel meetings to take place. Security measures remain to a high standard, the building is accessible to wheelchair users. Cares (NFP) Ltd T/A Foster Cares Page 33

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The intended outcome for the following set of standards is:

• The agency fostering services are financially viable and appropriate and timely payments are made to foster carers.

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The agency ensures it is financially viable at all times and has sufficient financial

resources to fulfil its obligations. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. At that time a recommendation was made for increased joint working between the finance department and Foster Cares so as to progress financial procedural issues and clarify certain matters. The registered manager has full budgetary control and regular liaison with agency accountants was reported to take place. Consideration to the budget for Foster Cares is undertaken on a weekly basis. Foster carers are expected to invoice the agency on a weekly basis and they are then paid direct using the BACS system.

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The financial processes/systems of the agency are properly operated and maintained

in accordance with sound and appropriate accounting standards and practice. Key Findings and Evidence Standard met? 3 This standard was fully met at the time of the last inspection. The agency directors continue to have regular financial meetings and financial reports are also compiled. An accountant is used to carry out regular external audits. Written information was provided to the inspector about the plans to increase recruitment of carers and additional sources of income were referred to, which would appear to support the ongoing financial viability of the agency.

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The financial processes/systems of the agency are properly operated and maintained

The registered person should ensure that financial procedures also taken into account the steps to be taken in situations of financial crisis as outlined within 27.2 of NMS. See recommendation 8. Cares (NFP) Ltd T/A Foster Cares Page 34

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cost of caring for each child or young person placed with him or her. Payments are

made promptly and at the agreed time. Allowances and fees are reviewed annually. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. Recommendations made at that time have been implemented so that the costs of specialist placements are outlined within the policy. These policies have recently been reviewed and there are systems in place so that annual review takes place. Financial polices and procedures are clearly outlined within the Foster Carers Handbook. Cares (NFP) Ltd T/A Foster Cares Page 35

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The intended outcome for the following set of standards is:

• Fostering panels are organised efficiently and effectively so as to ensure that

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Fostering panels have clear written policies and procedures, which are implemented

in practice, about the handling of their functions. Key Findings and Evidence Standard met? 3 This standard was met at the time of the last inspection. The requirements and recommendations previously made at the time of the last inspection have been met. Panel was not observed during the course of the inspection due to the unavailability of the inspector. The registered manager reported improvements with regards to recruitment of panel members. Two written references for each panel member are taken up. A young person has also been appointed to panel.

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Fostering panels have clear written policies and procedures, which are implemented

The registered person must ensure that all panel minutes make clear the reasons for recommendations. See requirement 2.

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Fostering panels have clear written policies and procedures, which are implemented

The registered person should ensure that panel procedures include guidance about decision making when all members of panel are not in agreement. See recommendation 7 Cares (NFP) Ltd T/A Foster Cares Page 36

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The intended outcome for the following set of standards is:

• When foster care is provided as a short-term break for a child, the arrangement recognises that the parents remain the main carers for the child.

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have policies and procedures, implemented in practice, to meet the particular needs

of children receiving short-term breaks. Key Findings and Evidence Standard met? 3 This standard was fully met at the time of the last inspection. The agency does not offer a specific short- term break service, however respite care is afforded to carers. Where this takes place this is by means of an identified approved carer with the Cares Agency. The agency continues to have number of carers who have been recruited specifically for this purpose. Cares (NFP) Ltd T/A Foster Cares Page 37

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The intended outcome for the following set of standards is:

• Local authority fostering services' policies and procedures for assessing,

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there is recognition of the particular relationship and position of family and friend

carers. Key Findings and Evidence Standard met? 9 The agency does not operate a service for assessing friends and families as carers. Cares (NFP) Ltd T/A Foster Cares Page 38

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Date

Cares (NFP) Ltd T/A Foster Cares Page 39

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comments/confirmation relating to the content and accuracy of the report for

We would welcome comments on the content of this report relating to the Inspection conducted on 22 November 2004 and any factual inaccuracies:

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comments/confirmation relating to the content and accuracy of the report for

Please limit your comments to one side of A4 if possible We are working on the best way to include provider responses in the published report. In the meantime responses received are available on request. Cares (NFP) Ltd T/A Foster Cares Page 40

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

Amendments to the report were necessary YES

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

Comments were received from the provider YES

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

Provider comments/factual amendments were incorporated into the final inspection report NO

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

YES Provider 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

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Note:

In instances where there is a major difference of view between the Inspector and the Registered Provider responsible Local Authority fostering service Manager both views will be made available on request to the Area Office.

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report:

Action plan was received at the point of publication YES

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report:

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

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report:

Action plan did not cover all the statutory requirements and required further discussion NO

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report:

Provider has declined to provide an action plan NO

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Public reports

It should be noted that all CSCI inspection reports are public documents. Reports on children’s homes are only obtainable on personal application to CSCI offices. Cares (NFP) Ltd T/A Foster Cares Page 41

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Registered Person’s or responsible Local Authority Manager’s statement of

agreement/comments: Please complete the relevant section that applies.

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inspection conducted on the above date(s) and that I agree with the statutory

requirements made and will seek to comply with these.

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Date

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

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Cares (NFP) Ltd T/A Foster Cares / 22nd November 2004

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

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Cares (NFP) Ltd T/A Foster Cares / 22nd November 2004

Telephone: 020 7979 2000 Fax: 020 7979 2111

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Cares (NFP) Ltd T/A Foster Cares / 22nd November 2004

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

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Cares (NFP) Ltd T/A Foster Cares / 22nd November 2004

S0000036057.V194291.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

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Cares (NFP) Ltd T/A Foster Cares / 22nd November 2004

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

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