The Banyan Tree

Unique reference number SC396186 Inspection date 01/09/2010 Inspector Christy Wannop Type of inspection Key

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Date of last inspection 12/01/2010 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children’s Services from: The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000.

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About this inspection

This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcomes for children set out in the Children Act 2004 and the relevant National Minimum Standards for the service.

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The inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough

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Brief description of the service

The home provides long-term care and support for up to four young people, between the ages of 10 and 17, who require support with their learning, emotional and behavioural needs. It is one of two homes operated by the same local company; the other is registered with the Care Quality Commission as a home for younger adults. The home is a large terraced house on three floors, with four bedrooms for young people and staff sleeping-in rooms. There is an office in the house and an annexe in the garden used as a separate office and meeting room. It is situated near to a range of amenities and is close the centre of a large town. There is not a Registered Manager at the home, although a manager has been appointed and is in day-to-day charge. The owner is a regular presence in the home. Three young people currently live at the home and all contributed their views.

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Summary

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

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Summary

This was an unannounced key inspection and looked at outcomes for children in the areas of being healthy, staying safe, enjoying and achieving, making a positive contribution, economic well-being and organisation. It also followed up on previous shortfalls against the national minimum standards. This inspection found outcomes for children are good and the service meets and exceeds many of the national minimum standards. The promotion of independence is strength, as is the understanding of young people's emotional needs and support to young people on the basis of their learning disabilities. There are some inconsistencies in documentation and record keeping, but these do not impact on the otherwise good care experienced by young people. This service provides a very positive and enabling environment where young people receive good health care, are safe and are encouraged in their individuality. Education is valued and young people have

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Summary

excellent leisure opportunities. Behaviour is well managed and there are good relationships between adults and young people.

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Improvements since the last inspection

The previous inspection found shortfalls against the national minimum standards for management monitoring of and young people's inclusion in record keeping after sanctions and restraints. Young people's individual records are now audited and signed by the manager, and young people are encouraged to record their comments if they wish. Young people's case records were previously found to lack staff signatures and parental consents. This is now improved. Young people were previously not informed about emergency evacuation procedures. They say that they are now actively involved in the health and safety checks and drills. Staff in charge of leading shifts were not always sufficiently experienced but this is no longer the case. An experienced and qualified member of staff leads each shift and young people experience well thought out, planned care.

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Helping children to be healthy

Young people's good health is promoted and they live in a healthy environment. Young people are fully involved in menu planning and are provided with a nutritious and healthy diet by staff who are trained in food hygiene. The kitchen has a welcoming family atmosphere and young people can, if they wish, shop for food and prepare meals and develop independent skills. Good attention is paid to ensuring young people are self aware about healthy choices. They are encouraged to take exercise and in general keep themselves fit and well. Staff work constructively to develop their understanding about dangers to their health from smoking and drug use though regular one-to-one key working sessions.

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Helping children to be healthy

Detailed health plans are in place and these support staff and young people in ensuring that physical and emotional health needs are properly identified, recorded and addressed. Young people say that staff care for them when they are unwell and when they attend routine and specialist health appointments. Young people's welfare is safeguarded by the home's policies, procedures and good practice for receipt, storage and administration of medicine and treatment; and staff have received training in the safe handling and administration of medication and in delivering first aid. The service provides skilful support to young people with learning, emotional and mental health needs. Staff have received training in transactional analysis which is an integrative approach to the theory of psychology and psychotherapy. Staff are supported in using this theory by a consultant psychologist who meets with them on a monthly basis. This adds an informed dimension when considering needs on the

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Helping children to be healthy

basis of learning disability .and leads to a consistent approach in supporting young people with their emotional needs and well-being. One social worker described the 'really good practice' in liaison and monitoring with health and social care professionals and working to agreed plans to reduce reliance on medication.

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Protecting children from harm or neglect and helping them stay safe

This service provides a safe and secure home for young people. Staff are sensitive and skilful and policy and procedure supports safe childcare practice. Young people enjoy good levels of privacy in the home and say they trust staff with personal information and that their confidentiality is respected. Staff act as ‘good parents' and offer careful support for personal care and when it is necessary to search for items which may cause harm to them. Young people are able to use a phone in private and have safe internet access to communicate with social workers, family and friends by email. Complaints are taken seriously and young people are confident in making representation or complaint if they are unhappy with any aspect of living in the home. Complaints about the home are investigated in accordance with the organisation's policy and the registered person takes care to communicate throughout with young people and involve them in the resolution.

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Protecting children from harm or neglect and helping them stay safe

Young people are safe, their welfare is promoted and they are protected from harm. Staff are clear about their responsibilities for child protection, are trained and have clear information about how to make a proper response if they are worried about abuse. However, policy and procedure has not yet been reviewed in the light of recently published local safeguarding board procedures. Young people say they feel secure at the home and social workers comment on how the service has kept young people safe. Staff know how to plan for safe care, including physical contact with young people, time alone, intimate care and invasive procedures, and can deliver safe care in practice. Young people do sometimes go missing from home. They are protected by good partnership working with local police when this happens and are returned home safely. Arrangements to reduce the impact of bullying are good and bullying is known to be unacceptable. Staff quickly protect vulnerable young people

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Protecting children from harm or neglect and helping them stay safe

from the dominant behaviour of others and work constructively with them to prevent bullying behaviour and consider the consequences of their actions. Behaviour is well managed through constructive range of techniques that focus of helping young people to understand their behaviour, to be calm and to talk to trusted adults when they feel angry. Young people say that sanctions are fair and staff talk about consequences and are non-punitive in their approach. Staff are trained in safe physical intervention, however, the service is committed to using prevention and diffusion techniques and restraint has not been used in the last twelve months. It is a strength of this home that adults and young people have good relationships based on mutual respect and differences are generally sorted out through negotiation. Recent reorganisation of recording systems means that there is no central home record of physical intervention and disciplinary measures, though young people have

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Protecting children from harm or neglect and helping them stay safe

The home is safe for young people because the manager takes good steps to reduce unnecessary risk and young people say they are involved in emergency evacuations and in testing the systems that prevent fire. There are generally good arrangements for managing risk in the environment, young people's activities and behaviour through a range of formal risk assessments. Young people enjoy really good holidays with the home, organised after careful and extensive planning, discussions and agreement with the owner, families and social workers. However, the minimal written risk assessment does not reflect this input. Young people are safeguarded from abuse by proper recruitment procedures for selecting and vetting all staff and volunteers, and the monitoring of visitors. The home does accept portability of Criminal Records Bureau(CRB) checks when it takes on staff who have previously worked in the home as properly recruited agency workers. The responsible individual

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Protecting children from harm or neglect and helping them stay safe

carries out a thorough risk assessment to ensure safety until their own CRB check is complete.

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Helping children achieve well and enjoy what they do

Young people get very good individualised personal care and staff value each young person as a person in their own right. They balance the needs of the individual with those of the group to ensure that young people who require higher levels of care get it. Key workers are sensitive and fully informed about individual needs and wishes and give help and guidance about personal, health, social and sex and relationship education. Young people know that their cultural, religious and racial identities are respected and that any additional support for mental or emotional or physical health needs will be organised. Prejudice is challenged and the importance of diversity is evident in young people's written placement plans and in key working sessions. A social worker described the careful matching of the needs of the young person with a chosen, trusted key worker as ' brilliant.'

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Helping children achieve well and enjoy what they do

Educational achievement is actively promoted and valued and is seen as part of preparation for adulthood. Young people overcome difficulties about school and staff are successful in helping them to be ready for learning, rested and well prepared. The input of staff has improved school attendance for young people with long established patterns of resisting education. One social worker described one young person as 'well supported in mainstream education.' He was positive about the pro- active approach of staff in helping them to make choices about further education and employment and in helping to write a curriculum vitae and preparation for attending interviews. Young people are well supported with homework through provision of safe internet access, books and resources, space and quiet for study. Opportunities for leisure are outstanding and individual hobbies are encouraged. Young people know that staff are interested in them, their likes and dislikes and will support

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Helping children achieve well and enjoy what they do

constructive hobbies. Staff have a healthy attitude to getting young people out and about in their local community and make good use of community facilities. Young people enjoy really imaginative holidays in this country and at children's camps in America. These are opportunities that challenge them to develop new skills and build confidence.

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Helping children make a positive contribution

Young people are involved with the community and society and do not engage in offending or anti-social behaviour. Good assessments, comprehensive care planning and review from the point of moving in to moving on or out, helps young people to develop positively and to know they are making progress. Their placement plans are of good quality, meaningful and are useful documents that help them to understand why they are there. All young people, including those with communication disabilities, are supported to be active in making decision about their lives and the service seeks specialist guidance about communication skills.

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Helping children make a positive contribution

Young people's needs and development are regularly reviewed. They know they are cared for and one young person commented on the difference he felt in the calm approach within the home, and that he felt he would benefit from staying at the home until he was 18. While the service makes excellent contributions to statutory reviews in person-centred reports, the decisions made at reviews and the formal review notes are not always evident on young people's files. Social workers confirm that staff are always supportive and that documentation for care planning and reviews are of good quality and produced on time.

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Helping children make a positive contribution

Young people are able to move into and leave the home in a planned and sensitive manner. The responsible individual makes sure that admissions are appropriate by carrying out extensive, in-depth assessments prior to admission. She gathers excellent information to ensure that the needs of the young person and those already living at the home are balanced, and also visits young people in their existing placements to make sure they understand and want to make a move. Similar careful attention is given to helping young people move on in a planned way. The service has provided stable, long standing and productive placements for a number of young people since it began operating in 2001.

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Helping children make a positive contribution

Staff help young people keep up positive relationships from their past or make new relationships with friends and family. They are sensitive to the impact that contact, or lack of it, can have on young people and support them to feel positive in maintaining a web of supportive relationships with friends and trusted adults from other areas of their lives. In this way they develop self-confidence and learn to successfully deal with significant life changes and challenges. Young people say they are listened to and have a clear voice in the home. They are consulted and their opinions respected. There are regular young people's meetings, individual key worker sessions, review processes, and good levels of communication with staff in day-to- day life. The responsible individual is a frequent presence at the house and young people have confidence that she takes their views seriously. All young people, including those with learning difficulties, are able to communicate their views

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Helping children make a positive contribution

because staff make the most of resources and communication aids, such as visual timetables and ensuring that they use the most appropriate form of communication.

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Achieving economic wellbeing

Young people receive care and active support that helps them to prepare for adulthood. Staff promote independence in their daily approach with young people. For example, young people are encouraged to use public transport, be involved in shopping for food and cooking, and cleaning their bedrooms. Young people learn not just skills, but the behaviours that relate to emotional maturity. There are a range of financial allowances available to young people and they are supported by staff in developing budgeting skills. Placing social workers are confident that the service is well able to support their young people into adulthood. Staff are able to provide a supportive outreach service to young people living independently or who wish to transfer into their second home for young adults, registered with the Care Quality Commission. Young people live in a well-designed and pleasant home with plenty of space and

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Achieving economic wellbeing

facilities to meet their needs. The interior and exterior décor is of a high standard and young people are provided with comfortable relaxing surroundings. There are plenty of rooms to give young people the choice of being alone or in company. The home is well equipped, and there is a large games room available in which young people can take part in a range of activities. For example there is there a pool table, a range of books, interactive games consoles, DVDs and art and craft materials. Young people are supported to personalise their bedrooms to that they have a relaxing and private place they can use when they want some time alone.

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Organisation

Young people live in a home that is organised around their needs and prioritises and seeks to improve their life experiences. The previous Registered Manager resigned in March 2010; a new manager has been appointed and an application to register with Ofsted has been made. The responsible individual is also the owner, and visits the home regularly. She is fully knowledgeable about each young person's needs and the organisation of care, and invests in the development of the service. Young people have good information they need about life in the home so they know what to expect, how they will be cared for and who they are likely to share with. Parents and placing authorities also have a clear statement about the operation of the home.

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Organisation

Staff management systems ensure competent, confident, experienced staff provide the right care for young people. Staff in charge of shifts have substantial experience and a good proportion have achieved National Vocational Qualification at level 3 in Caring for Children and Young People. There are generally enough adults to care for young people although there have been periods of short staffing. Two staff care for three young people during the day and at night. There is now a core of five permanent staff attached to this home, but they may provide cover to the other house operated by the company. Young people comment that they do not like this. Continuity is achieved by a mix of known male and female staff from a diverse range of backgrounds and experience.

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Organisation

The promotion of equality and diversity is good. Policies, procedures and good practice helps young people to know that their individual needs on the basis of race, ethnicity, disability, sexuality, gender, age and religion are valued and the service is able to meet their diverse needs in everyday life in the home. Staff provide security and give specific support for young people's ethnic and cultural backgrounds and disabilities. Training and development opportunities are linked to the needs of the young people and the purpose of the home. Staff are themselves supported and guided in safeguarding and promoting the young people’s welfare through professional supervision by experienced senior staff. Social workers report 'close and consistent' relationships with the service.

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Organisation

The welfare of the young people in the home is promoted by regular monitoring by the person carrying on the home, and consultant managers have also given support in the period of managerial transition and have carried out monthly Regulation 33 visits, reporting on the quality of the service. Record keeping and management monitoring is satisfactory, though some central records for the home do not always enable an overview of patterns and trends for the service. While young people have good personal records of incidents and times when they go missing, the home does not maintain its own permanent record. Similarly the service has recently also changed the way it maintains the official records of physical intervention and disciplinary measures. Young people have good individual records of this, but there is not a central record for review as part of the manager's monthly monitoring. This new system no longer enables a good overview by the manager of patterns and

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Organisation

trends of behaviour and the effectiveness of staff in resolving incidents, nor does it contribute to a broader quality review of the service.

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Organisation

Young people's individual records and care files are well maintained and contain comprehensive information that give a clear picture of their life experiences and needs. They are securely stored and young people say they can access and add personal statements, but they choose not to. The records form a thorough contribution to the young person's progress and development.

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s):

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Recommendations

 maintain separate home records for the home about the use of restraint and sanctions (NMS 22.9)  submit safeguarding procedures for consideration and comment to the local safeguarding advisor to ensure consistency (NMS 17.4)  ensure risk assessments are carried out, recorded and reviewed for children's activities, for example, to ensure physical safety and security while going on holiday (NMS 26.2)  ensure the result of all statutory reviews are recorded on the child's file and that written copies of reviews are made available to children (NMS 3.6)  ensure the system for monitoring Schedule 6 matters is able to identify any patterns or issues requiring action, for example, through central records of physical intervention, use of disciplinary measures, child protection concerns and when children go missing. (NMS 33.1)

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