Children's Home run by Keys Education Ltd in South Gloucestershire

Unique reference number SC067561 Inspection date 13/09/2010 Inspector Barbara Davies Type of inspection Random

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Date of last inspection 12/04/2010 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 is registered to provide care for three children of either gender between the ages of 11 and under 18 years. It is a modern town house in an urban area. It is domestic in style with modern fixtures and fittings. The accommodation is spread out over three floors. The ground floor has a kitchen/dining room leading to a laundry equipped with washing machine and tumble dryer. A sitting room is equipped with television and DVD facilities. The first floor has a bathroom with toilet/shower/bath and whirlpool bath facilities. There are also two children's bedrooms located on the first floor landing and a staff office doubles up as a sleeping-in room. A second staff sleeping-in room is located on the second floor in close proximity to a bedroom for a third child. The staff room is en-suite and bathroom facilities provided are the same as on the first floor. External features include a garage and small front and rear

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Brief description of the service

gardens. Shopping and recreational facilities are within close proximity of the home and there are public transport links to the city centre. National rail links are also easily accessible.

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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 interim inspection. The key standards in staying safe were inspected as were actions and recommendations made at the previous inspection. The overall judgement following the inspection is that the home provides a good standard of care with some satisfactory elements. This inspection found that the home is undergoing a period of instability with young people largely not conforming to the rules and expectations. The registered manager is considering whether the home is able to meet the needs of young people and is using the statutory review process to consult with placing authorities over this matter.

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Improvements since the last inspection

Following the previous inspection of the home, the provider was required and recommended to make improvements to the contents of placement plans to show the strategies being used to help young people prepare for independence. The majority of young people currently accommodated are not of an age where leaving care plans are required. Pathway plans have been requested from placing authorities for those young people for whom a move to independence is imminent. The matters raised are considered to have been met. Improvements were also required to written records kept in respect of medication administered to young people. This has not yet been satisfied with details still not being recorded of the reason for homely remedies being administered or the dose given. The absence of these details does not facilitate good monitoring of health needs. The registered manager was also required to update the record of complaints to show the outcome of investigations. This matter

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Improvements since the last inspection

has also not been addressed. A final action regarding the regular updating of the duty roster to indicate when staff have worked shifts in other homes has been satisfied, allowing better monitoring of staffing arrangements.

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Helping children to be healthy

Not all key standards have been inspected and the judgement remains as it was following the key inspection of the home in April 2009. At that time some shortfalls were noted with regard to the recording of non-prescribed medication issued. The reason for administration of homely remedies to be recorded or the dose is still not being recorded. Information is therefore incomplete and does not inform staff whether a medication review is necessary. The action has therefore been repeated following this inspection. The medication policy requires that homely remedies should not routinely be kept in the home. This means that potentially young people cannot seek prompt relief from pain for minor ailments such as headache or stomach ache without first consulting a doctor and receiving a prescription. This is not comparable with what would happen in most families. Should both young people require a homely remedy at the same time, the amount of medication stored in the home is

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Helping children to be healthy

unnecessarily increased, by this system. The policy also states that homely remedies may be kept in the home but does not specify the circumstances in which this would be permitted or name the types of remedies permitted. The system for recording medication as it is administered is the same for both prescribed and non-prescribed medication.

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Protecting children from harm or neglect and helping them stay safe

Robust procedures protect young people from abuse and the privacy of young people is respected and promoted. Locks on bedroom doors enable young people to keep their possessions safe and allow them some control over who enters their bedroom. Confidential information is locked in filing cabinets in the office. Young people are informed of their rights and know they can request to read information recorded about them. The home has a policy which permits and requires staff to conduct a search of young people's bedrooms if, for instance, they suspect illegal drugs are being held on the premises. Currently the policy is not consistently being implemented due to the risk of harm to staff, from physical challenges by young people. The welfare of young people is therefore compromised. The home is taking appropriate action to review the suitability of placements with placing authorities.

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Protecting children from harm or neglect and helping them stay safe

Staff inform young people about the home's complaints procedure and that of their placing authority. Young people understand the complaints process but it is seldom used. Most concerns are raised and resolved through discussion with staff. Good practice is evident with young people being informed in writing of the outcome to their complaint. Outcomes are however not recorded in the home's record of complaints which does not allow effective monitoring of issues. Young people generally express satisfaction with the way the home operates although some express concerns around the arrangements for the purchase and accessibility of food. Discussion of this issue with the Registered Manager confirmed that sufficient provision is made in both instances.

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Protecting children from harm or neglect and helping them stay safe

Staff are trained to recognise indicators of abuse and follow the correct reporting procedures when safeguarding concerns arise.

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Protecting children from harm or neglect and helping them stay safe

Bullying is not reported to be an issue although the admission of some young people to the home has affected the dynamics of the group. This is currently posing some challenges for staff to manage and, in some instances, preventing planned interventions, such as re-integration to education, from taking place. Although encountering some resistance, staff are attempting to engage young people in separate activities so they can begin to address their individual needs.

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Protecting children from harm or neglect and helping them stay safe

Records show that there has been an increase in the occasions when young people are absent from the home without permission. In these circumstances, staff consistently follow the home's missing person protocol to ensure that young people are located promptly. Placing social workers are satisfied with the action being taken in response to absconding and report being well-informed following each incident. Ofsted has, however, not been informed as is required when there have been absences which have been reported to the police.

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Protecting children from harm or neglect and helping them stay safe

Young people are not currently conforming to the rules of the expectations of the home, in particular not complying to bed-time and morning routines. Due to the risks presented, staff are unable to effectively challenge behaviour and implement firm boundaries. They are however skilfully de-escalating conflict situations and successfully reducing the need for sanctions and physical restraint. The risk of physical assault on staff by young people is also being managed well. In order to manage the home safely, the standard of care provided is being compromised. As previously indicated, the issues are being proactively addressed with reviews having been scheduled to consider the suitability of placements and agree strategies to confront the behaviour displayed.

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Protecting children from harm or neglect and helping them stay safe

There is evidence of excellent communication between the staff and the placing authorities to inform them of serious incidents. Police have not routinely been consulted over several incidents involving the use of illegal substances and the home's policy on this does not provide clear guidance to staff about the circumstances when this should occur. The Registered Manager has indicated a commitment to meet with the local police to agree a protocol.

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Protecting children from harm or neglect and helping them stay safe

A safe physical environment is provided for young people and staff. Staff receive basic training in health and safety and complete more comprehensive training in matters such as fire and food safety. Weekly checks on the fire alarm system and regular maintenance of mechanical equipment, such as boilers, ensures that all equipment remains in good working order and is safe. Young people take part in fire drills so that they know what to do in the event of a fire. Any activities in which young people participate are risk assessed and appropriate safeguards identified.

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Protecting children from harm or neglect and helping them stay safe

Recruitment records were not inspected as part of this inspection. A separate inspection of records held centrally was conducted in August 2009. That inspection concluded that recruitment checks for permanent staff conform to regulations and determine whether people are suitable to work with young people.

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Helping children make a positive contribution

The home's placement plan shows the strategies currently being used by the home to work with young people. However, following admission of some young people to the home, there have been no formal meetings with the placing authority, to discuss and agree plans of care, although statutory reviews are now scheduled. Outcomes of informal meetings that have taken place to discuss placement plans, have not been recorded on young people's files. There is therefore no indication of the follow-up action to be taken when young people do not co-operate with their care, for instance when refusing to attend health appointments. It is therefore not clear how the interests of young people are being promoted in such circumstances.

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Organisation

Not all key standards have been inspected and the judgement remains as at the previous inspection. An action was set at the previous inspection for movement of staff between homes to be recorded on the duty roster. This has been implemented.

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Statutory Requirements

This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales.

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Std. Action Due date

13 ensure that the homely remedies policy is reviewed in relation to homely remedies that may be kept in the home and ensure suitable arrangements are in place for the recording of medication administered - (this relates to recording the administration of homely remedies to include the reason and dose) (Regulation 21 (1)) 29/10/2010

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Std. Action Due date

16 ensure that a written record is made of any complaint and its outcome (Regulation 24(5)) 15/10/2010

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Std. Action Due date

20 ensure that if any event listed in column 1 of the table in schedule 5 takes place, the registered person, shall without delay notify the persons indicated in respect of the event in column 2 of the table (this refers to incidents of absconding that have necessitated the involvementof the police) (Regulation 30 (1)) 29/10/2010

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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

 ensure that the policy and guidance relating to police involvement in the home provides clear guidance to staff about when this should occur in relation to illegal substances. Also meet with local police to review and agree the protocol (NMS 22. 15)  ensure that the result of all statutory reviews and reviews of placement plans are recorded on the child's file, and individuals responsible for pursuing actions at the home arising from reviews are clearly identified (NMS 3.4)

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