Children's Home run by Hampshire County Council in Hampshire

Unique reference number SC033174 Inspection date 18/11/2010 Inspector Maire Atherton Type of inspection Key

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Date of last inspection 02/02/2010 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

This is a local authority children's home that provides care and accommodation for six children and young people of either gender. The home aims to provide a period of stability for children and young people with complex needs in an environment with a therapeutic emphasis. In addition, there is multi-agency involvement in addressing their needs. Children and young people stay at the home for periods in excess of six months. They are helped to return to their families, move to substitute family placements or to more independent placements. The home is located in a rural setting with local facilities in close proximity.

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Summary

The overall quality rating is satisfactory.

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Summary

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

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Summary

This unannounced inspection looked at all the key standards. There is a competent, stable staff and management team in post. The establishment of good individual relationships between the staff and young people is a real strength of the service, as is the provision of activities. Young people are clear that staff provide them with information and advice about how to keep themselves safe but they often choose to disregard this.

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Summary

A number of the actions set in this report arise from the pattern of admissions to and discharges from the unit which create consistently changing group dynamics. The failure to assess the potential impact of this as part of the referral and admission process has led to the creation of a group of young people with risky and challenging behaviour that has led to safeguarding concerns. These have recently significantly diminished as a number of young people have moved to alternative placements. The manager of the unit does not have an equal say in the admission of young people to the home, in part driven by the needs of the local authority to find placements at very short notice in circumstances outside its control. Staff are skilled at identifying the risks to young people and there are strong links with the Public Protection Unit.

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Improvements since the last inspection

There were no actions or recommendations arising from the last inspection.

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Helping children to be healthy

Young people are provided with lots of information about healthy living but choose which facets of the advice they will act on. Staff prepare meals using fresh ingredients that are balanced and nutritious. They encourage young people to try different tastes. Young people may choose an alternative if they do not like what is on offer. Staff endeavour to get young people to contribute to menu planning and sometimes achieve this. Whilst staff aim for mealtimes to be a social occasion shared by the group they adopt a flexible, pragmatic approach, thus ensuring young people eat well. Young people sometimes choose to get involved with food preparation, with support from staff.

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Helping children to be healthy

There is a pattern of regular visiting by health professionals, for example, a looked after children's nurse and a representative from the child and adolescent mental health service. This enables young people to establish relationships with people who can answer their health-related queries. Where there have been recent changes of personnel the work on establishing relationships is beginning again. Staff work effectively with young people to ensure that routine healthcare appointments are made and health needs identified while in placement are addressed promptly, for example, attendance at a sexual health clinic. There is a lack of information on the health background of the young people, particularly regarding specialist needs mentioned in referral documentation.

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Helping children to be healthy

The administration and disposal of medication is insufficiently robust. For example there are inconsistent patterns of the administration of antibiotics and the stock control and disposal of controlled drugs is not in accordance with guidance from the Royal Pharmaceutical Society. Staff are first aid trained and there are good systems in place that ensure first aid boxes are available and properly equipped should they be needed.

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Protecting children from harm or neglect and helping them stay safe

The staff team work hard to keep young people safe. The young people placed in the home have very significant needs and some of these are expressed through highly challenging and risky behaviour. Young people say that staff talk to them about how to keep themselves safe and acknowledge that some of the choices they make put themselves at risk.

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Protecting children from harm or neglect and helping them stay safe

The privacy of young people is promoted within a considered framework of safeguarding issues that are known and shared by staff with the young people, for example, supporting the police to conduct bedroom searches to assist looking for young people absent without authority. There may be occasions when young people's access to telephones and the internet are restricted as this has proved effective in reducing absconding and this information is clearly specified in the plans for young people. Staff are committed to building and maintaining relationships with the young people. This means that staff manage day-to-day grumbles through negotiation, so that young people have a clear understanding of their responsibilities as well as their rights. It also reduces use of the formal complaints system. Staff support young people in making formal complaints, including use of the judicial system where this is appropriate. Staff convey a clear message that bullying in any

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Protecting children from harm or neglect and helping them stay safe

form, including racism, is not acceptable and support any young people subjected to bullying. There are systems in place to counteract bullying, but the identified actions are not always sufficiently timely, particularly when responsibility for an action is outside the control of the home.

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Protecting children from harm or neglect and helping them stay safe

Staff have a good understanding of child protection issues, underpinned by training. Young people say that staff talk to them about how their behaviour makes them vulnerable and get them to think about this. Young people appreciate staff efforts and sometimes act on the advice given, for example, keeping in touch while out. There have been high levels of absconding, linked to significant child protection concerns. Records show that child protection investigations have been initiated and planned by placing social workers but this information has not been shared with staff in the home. There is prompt liaison with relevant professionals, including the police at a local level and the representative from the Public Protection Unit, through attendance at strategy meetings, for example. Staff and the police work co- operatively to promote the welfare of young people, sharing information, such as the careful monitoring of communication with young people. There are detailed

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Protecting children from harm or neglect and helping them stay safe

safeguarding plans in place which include information for young people and guidance for staff on prevention and intervention strategies, incorporating advice from mental health professionals, to be used to deter absconding. Individual risk assessments are in place, including strategies to minimise risk for individuals. There is no evidence, however, that individual risk assessments are considered in the light of the needs and behaviour of other young people resident.

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Protecting children from harm or neglect and helping them stay safe

Staff are trained in an approved behaviour management technique that includes physical intervention but with an emphasis on de-escalation techniques and the provision of incentives to achieve acceptable behaviour. The physical intervention policy is in the process of being updated as the current document is dated 2003. Staff carefully consider the use of sanctions and promote a restorative justice approach where possible. There is a high level of challenging and aggressive behaviour resulting in the use of some physical intervention, the record of which is incomplete. Not all required notifications are submitted to Ofsted. Staff are calm and measured in their response to young people and continue to try and positively engage the young people with varying degrees of success.

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Protecting children from harm or neglect and helping them stay safe

Health and safety in the home is generally well managed. There are clear systems in place for assessing and responding to environmental and individual risks. The range of service records and checks required are up to date with one exception, that of the electrical installation in the house.

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Protecting children from harm or neglect and helping them stay safe

There have been no new staff appointments since the last inspection. There is a robust system for recording and monitoring visitors to the home.

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Helping children achieve well and enjoy what they do

Staff have a clear focus on meeting the individual support needs of the young people and are consistent in offering this regardless of the attitude and response of young people. There is an established key worker system in place, with two workers allocated to each young person. Young people can, and do, approach any member of staff with personal concerns. Staff are aware that the mix of young people placed is rarely conducive to successful group work. Staff are aware of and strive to address any issues of isolation or vulnerability within the group. Attitudes, language and behaviour that may be interpreted as discriminatory are appropriately challenged.

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Helping children achieve well and enjoy what they do

No young people are in full-time education and not all have a current personal education plan. The education resources within the county are not readily available to meet the needs of the young people in the home. Staff work creatively to provide young people with things to do. Young people say 'staff are good at activities' and give this as a real strength of the home, for example, finding work experience placements in a stables and a veterinary clinic.

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Helping children make a positive contribution

The pattern of admissions to the home is not always within the span of control of the manager and at times is dictated by resource issues of the local authority, For example, a private provider terminated a placement at very short notice providing very limited opportunity for a planned admission. In addition, some placements are not supported by the necessary documentation prior to or on admission, despite frequent requests by staff for this information. While there is evidence that the needs of young people have been assessed and evaluated in the light of the Statement of Purpose for the home, there is no evidence that these needs were fully considered in the light of the needs and behaviour of the other young people already resident. This led to a volatile group composition that was highly challenging to manage as well as significantly increasing risks to some young people placed. In this context group

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Helping children make a positive contribution

work and consultation has not been viable and staff consult with young people on an individual basis, using the positive relationships established between individual young people and the staff team.

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Helping children make a positive contribution

Reviews are held regularly and key workers ensure that the views of the young people are represented should they opt not to attend. There can be some delay in implementing the outcome of reviews when this is outside the control of the home, such as the identification of an alternative placement for example. Plans for moving in and moving on are often in response to immediate pressures, such as court proceedings and risk assessment, which provide limited opportunity for proper planning and preparation. Young people receive very good support from staff in both maintaining and establishing contact with family and friends where this has been agreed. Young people say that staff are good at supervising contact and are sensitive in their approach.

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Achieving economic wellbeing

Young people are encouraged to develop independent living skills, for example, with pocket money as an incentive for some household tasks, a clean and tidy bedroom. However, as a group there is a general reluctance to engage in transition planning and no young people have Pathway Plans.

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Achieving economic wellbeing

Since the last inspection, carpet on the ground floor has been replaced by laminate flooring and some redecoration has taken place. However, this has had little impact and the accommodation fails to provide a comfortable, homely environment. This is in part due to the layout of the home and the actions of young people in sabotaging the efforts of staff to soften an institutional environment, for example, breaking furniture and pictures. The shortfalls in the accommodation have been recognised by the local authority and plans have been drawn up and funding agreed for the redevelopment of the home, including the provision of additional communal space and more equitable bedroom sizes. A start date has not yet been agreed; the manager understands that it will be before the end of March 2011.

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Organisation

The Statement of Purpose for the home has not been reviewed in the past year. It is unclear if the current statement has been approved by the elected members of the local authority.

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Organisation

There is an experienced and committed manager, described by staff as supportive and enabling. There is an established staff team in post, most of whom have relevant qualifications and benefit from regular training. This means that young people are cared for by a competent team that know them well as individuals. The team includes two social pedagogues who are part of a nationwide pilot project. Staff are enthusiastic about the potential of this project, but frustrated that so little progress has been made due to the extremely challenging behaviour and complex needs of the young people in placement. There is a minimum of three member of staff on duty during the waking day and two sleep in overnight. There are two full-time and one half-time vacant posts, frozen pending a review of residential services across the county. Shortfalls in staffing are addressed by the deployment of permanent staff working overtime or bank and agency staff known to the unit. When care plans have

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Organisation

required one-to-one staffing this is mainly managed within the usual staffing levels. This can reduce the availability of staff for other young people resident and may restrict their activities and/or opportunities for one-to-one with staff, thus limiting the potential to develop strong attachments from the established relationships.

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Organisation

Formal supervision of staff does not occur at the required frequency but the manager provides informal supervision when needed and attends handovers on a regular basis. In addition, staff meetings are held twice a month, one off site as when young people are at home during the day they are invited to attend the staff meeting in the home. There are good systems in place to identify areas for improvement and there are opportunities for staff to address these, such as, a recent team development day.

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Organisation

The management has strong systems in place for monitoring the performance of the home and the manager writes a detailed quarterly report for senior managers. While there is evidence that the assessed needs of individual young people can be met within the home, there is no evidence of a full evaluation of the compatibility of these needs with the resident group prior to admission. As previously noted, this led to the creation of a volatile group of young people with challenging and risky behaviour. These risks have reduced as some young people have moved on.

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Organisation

Records are well maintained and securely stored and staff demonstrate a good awareness of how to promote the privacy and confidentiality of young people.

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Organisation

The promotion of equality and diversity is good. The home is careful to meet the needs of young people as individuals, despite the challenges provided by the group dynamics. Young people understand that discrimination of any kind is not tolerated in the home and discriminatory comments are robustly challenged by staff.

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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 accurate records are maintained of the administration and disposal of medication (Children's Homes Regulations 2001 (21) (1)) 07/01/2011

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Std. Action Due date

17 ensure that staff are informed of and contribute to any child protection investigations concerning young people placed in the home (Children's Homes Regulations 2001 (2) (a)) 31/12/2010

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Std. Action Due date

20 ensure that notifications to Ofsted are made in accordance with Schedule 5 of Children's Homes Regulations 2001 (30)(1)) 07/01/2011

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Std. Action Due date

22 ensure that a full record is maintained of the use of any physical intervention (Children's Homes Regulations 2001 (17)(4)) 31/12/2010

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Std. Action Due date

14 promote the education of young people, in particular ensure 31/01/2011 that there is a current personal education plan in place for each young person (Children's Homes Regulations 2001 (18)(1)) 2 evidence that all placements are considered in the light of the needs and behaviour of other young people resident (Children's Homes Regulations 2001 (11) (1)(a)) 07/01/2011

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Std. Action Due date

2 ensure that the manager of the home is an equal partner in the decision-making process for all admissions to the home so as to evidence compliance with Children's Homes Regulations 2001 (9)(1) 31/12/2010

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Std. Action Due date

2 ensure that there is a current placement plan in place when young people are admitted to the home (Children's Homes Regulations 2001 (28)(1) Schedule 3 (18)) 31/12/2010

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Std. Action Due date

24 improve and maintain the premises so as to provide suitable accommodation for young people (Children's Homes Regulations 2001 (31)(1)(2)) 31/03/2011

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Std. Action Due date

28 ensure staff receive supervision at the required frequency. (Children's Homes Regulations 2001 (27)(4)(a)) 31/01/2011

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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 all young people have a clearly written health plan that includes full information on the health background of the young people (NMS 12)  consider how identified actions to counteract bullying can be made more effective and timely (NMS 18.5)  undertake checks of electrical installations at least every three years (NMS 26.4)  review the Statement of Purpose of the home and evidence formal approval by the elected members of the local authority. (NMS 1.5)

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