Children's Home run by Laurel Leaf Homes Ltd in Newham

Unique reference number SC060545 Inspection date 15/09/2010 Inspector Joanna Heller Type of inspection Key

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Date of last inspection 28/04/2010 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 take eight children, aged 10 to 16 years, with learning disabilities or emotional and behavioural difficulties. The property is a large extended corner house. There are eight en suite bedrooms, including three on the ground floor, a lounge, games room, staff room, office, kitchen, two shower rooms and one bathroom. The home is situated in a central area on the outskirts of a large city close to public transport and many local amenities.

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Summary

The overall quality rating is inadequate - notice of action to improve.

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Summary

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

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Summary

This was a full unannounced inspection and all key standards in each of the outcome areas were reviewed. One young person was involved in the inspection. The home has succeeded in improving practice in the recruitment of staff and maintenance of the building. Staff work with young people who are refusing to engage with professional services.

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Improvements since the last inspection

At the last inspection a number of actions were set regarding the standard of equipment and the building, health and safety, staff recruitment, medication management and care planning. The provider and staff have taken action to address the shortfalls identified.

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Improvements since the last inspection

Further improvements are required to the actions and recommendation set at the last inspection relating to management of behaviour, admission processes, risk assessment, opportunities for activities, and staff supervision.

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Helping children to be healthy

Young people benefit from a variety of nutritious home cooked foods that reflect people's choices and cultural heritage. Young people enjoy the meals prepared and have an active role in choosing the menu for the week. Staff encourage young people to develop cooking skills through preparing some meals, however, young people are often resistant to this, preferring staff to do it. Similarly staff encourage young people to get involved in the household shopping, but young people have declined to be involved. Healthy snacks are freely available. Staff ensure young people have access to appropriate health services such as doctors, dentists and opticians. Reward systems are in place to encourage young people to attend these appointments. Health plans are in place for each young person, but key information, such as whether vaccinations have been completed since the last review is not detailed. No information is freely available for young

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Helping children to be healthy

people regarding health promotion. Keyworking discussions demonstrate that staff discuss health issues on an individual basis as they arise.

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Helping children to be healthy

The home has safe systems in place for the storage of medication. Few staff are trained in managing medication, however medication training is booked to take place within the next few weeks and all staff are required to attend. Clear records are held of medication given and coming into and leaving the home. Insufficient staff are trained in first aid.

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Protecting children from harm or neglect and helping them stay safe

Staff ensure young people enjoy privacy within the home. Staff knock on bedroom doors before entering and all bedroom and bathroom doors are lockable. Staff demonstrate an awareness of the principles of confidentiality and records are suitably stored.

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Protecting children from harm or neglect and helping them stay safe

The home is able to evidence that complaints are effectively responded to, investigated and managed. Young people know how to complain and have confidence in the home's ability to respond to any issues of concern they may raise. Staff are aware what to do should an incident of a child protection nature occur. All staff have received training which is regularly updated. However, no information regarding children's rights and outside organisations to contact in the event of not feeling safe is freely available for young people. Issues of bullying are not currently an issue, however there is no evidence of information given or any proactive work in this area.

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Protecting children from harm or neglect and helping them stay safe

Young people who go missing are notified to the appropriate agencies in line with local guidelines. Risk assessments are in place for young people, which identify key areas of vulnerability and any risks they may pose to others. However, these are not always accurate. For example, one young person is detailed as not being an absconder but having ‘poor timekeeping issues’; this young person was regularly missing from care. Similarly, information disclosed in the core assessment was not on all occasions transferred across to the risk assessment, such as potential self- harming risks.

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Protecting children from harm or neglect and helping them stay safe

Few sanctions are applied and young people confirm that the rules are fair. Young people stated that there are no real consequences of any inappropriate behaviour, but also, that there are no systems in place to effectively promote positive behaviour. Staff are not always fully aware of the homes sanctions policy and the application of permissible sanctions. For example, a staff member during a statutory review advised placing authority managers it was appropriate to apply a financial sanction for non- cooperation in attending medical appointments.

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Protecting children from harm or neglect and helping them stay safe

Staff receive training in managing challenging behaviour and safe restraint; this is updated regularly. Records maintained of physical intervention and restraint are not kept up-to-date. For example, incident reports and discussions with staff indicate that there have been at least two recent events where restraint and physical intervention has been appropriately applied to separate fights between young people. Neither of these incidents are detailed in the restraint log and incident records do not detail the restraint or physical contact applied.

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Protecting children from harm or neglect and helping them stay safe

The provider has suitable systems in place to ensure the ongoing safety of the building. Fire prevention arrangements in the home ensure young people and staff are safeguarded from fire in line with current good practice. Fire drills are carried out regularly, however the recording of these does not demonstrate all young people have received training in how to evacuate the building.

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Protecting children from harm or neglect and helping them stay safe

Young people are now safeguarded from unsuitable people gaining employment in the home through robust vetting practices. However, management failed to take up appropriate checks when the employment of one member of staff transferred from an agency to being directly employed by the home. Having identified this through monitoring visits the acting manager took immediate action to safeguard young people.

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Helping children achieve well and enjoy what they do

Each young person has an individual plan of care drawn up from the core assessment provided at the point of placement. Management fail to ensure that these care plans are sufficiently detailed as to address all care needs from the point of placement. The information provided prior to, or at the point of placement, is often limited and the information gained is not always effectively carried across into care plans. For example, it was identified that one young person had previously had an incident of self-harming. This was not explored further, nor were any references to any risks incorporated into the care plan.

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Helping children achieve well and enjoy what they do

Both young people living in the home on a daily basis are female. On a number of occasions during both day and night the only two staff on duty are male. On one occasion there was no female staff on duty over a 24 hour period. This may limit the ability of young women to talk openly or access appropriate support from someone of the same gender.

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Helping children achieve well and enjoy what they do

Staff ensure that young people are appropriately supported with their education. School attendance is raised in keyworking sessions with the importance of education stressed. Staff are proactive in attempting to secure an educational placement for young people when they move into the home and attend key educational events as appropriate. Opportunities for activities are limited. Staff ensure young people are able to access games, books and appropriate magazines. Young people are choosing to spend their time out with their friends and are declining to engage in planned activities. However, there is little evidence that staff are proactive in promoting activities.

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Helping children make a positive contribution

The majority of placements made at the home are required as an emergency. The service is not specialising in emergency admissions and, therefore, does not have good systems to manage this.

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Helping children make a positive contribution

Prior to, or as soon as possible after admission, management ensure that a copy of the placing authority core assessment of need is obtained and a placement planning meeting held. The information is then developed into a basic plan of care. Management do not fully ensure that care is effectively reviewed regularly. Actions identified in the main care plan are not carried across into the monthly care plan, such as ensuring a young person is registered with a doctor or whether vaccinations are completed.

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Helping children make a positive contribution

Staff consult young people on all aspects of their day-to-day care and ensure they are involved in the statutory reviewing process according to their choice. Young people enjoy regular contact with their family and friends according to their choice. Any prohibited contacts are established at the point of admission.

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Achieving economic wellbeing

No young people have pathway plans to support the development of their skills for adult life. Staff do, however, ensure that young people are informally encouraged to develop independence skills, such as managing their own laundry and preparing basic snacks.

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Achieving economic wellbeing

The building has been subject of a programme of redecoration throughout communal areas that has resulted in a significant improvement within the communal areas of the building. The kitchen is currently in the process of being refurbished. Accommodation is set over the ground and first floor with office and meeting rooms situated on the second floor. Sufficient bathrooms and communal space is provided ensuring that the home meets young people's spatial needs. Furniture provided is suitable to meet the needs of the young people. Each young person has their own bedroom which is lockable.

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Achieving economic wellbeing

The transient nature of the home for many young people means that young people are unaware whether they are able to personalise these rooms, which are somewhat bare and uninviting. Bedding provided is provided from stock and one young person showed how it is on occasion stained and not fit for purpose, similarly this young person's bedroom carpet was stained. Young people referred to the home as being institutional and unwelcoming.

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Organisation

The promotion of equality and diversity is satisfactory. While staff are recruited from diverse backgrounds are able to provide positive cultural role models, young women do not always have access to female staff for personal support and guidance.

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Organisation

Management ensure that staffing levels are sufficiently high to meet the needs of young people. A minimum of two staff are on duty day and night. Staffing allocation, however, fails to meet the individual needs of young women. Male staff are regularly on duty together with no female staff on site, on at least one occasion no female staff was on site for a 24 hour period. This may mean young women may feel unable to talk to anyone about sensitive matters and impact on behaviour management within the home. This is also not best practice in relation to safeguarding.

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Organisation

Staff are on occasion given responsibility not commensurate with their experience. For example, staff who have yet to complete their induction were expected to represent the home at a statutory review. A further example, is staff rostered as the senior on duty within six months of beginning a career in residential child care.

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Organisation

The manager left the home three months ago and interim management arrangements are in place. The lack of Registered Manager impacts on staff leadership and the ability to ensure actions form the previous inspection are effectively addressed. Information regarding who is responsible for the management of the home is unclear as the Statement of purpose has not been reviewed and updated.

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Organisation

Management fail to ensure staff are fully supported and aware of whether they are performing well. For example, staff do not receive individual one-to-one supervision sufficiently regularly, do not have a personal development plan or an annual appraisal. Detailed induction processes are in place, but staff does not always complete all key areas before the end of their probationary period.

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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

12 ensure that at all times at least one member of staff on duty has a suitable first aid qualification (Regulation 20 (2) (e)) 26/10/2010

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Std. Action Due date

12 ensure young people's health is promoted and protected. In particular ensure young people's health care plans are reviewed and updated regularly (Regulation 12) 26/10/2010

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Std. Action Due date

13 ensure suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines. In particular ensure staff are trained in the safe management of medication (Regulation 21) 26/10/2010

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Std. Action Due date

22 ensure staff are aware of the behaviour management policy in the home in particular prohibited sanctions and controls (Regulation 17) 26/10/2010

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Std. Action Due date

22 conduct a review of the behaviour management in the home, in particular how appropriate behaviour is to be promoted (Regulation 17) 26/10/2010

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Std. Action Due date

22 ensure that within 24 hours of the use of any measure of control, discipline or restraint that a written record is made in a volume kept for the purpose (Regulation 17(4)) 26/10/2010

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Std. Action Due date

17 ensure unnecessary risks are identified and as far as possible eliminated, in particular ensure effective risk assessments are in place relating to children’s needs and vulnerability (Regulation 23) 26/10/2010

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Std. Action Due date

24 ensure young people are suitably supplied with bedding and linens which are fit for purpose (Regulation 31 (8)(b) 26/10/2010

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Std. Action Due date

7 ensure care plans developed at the point of admission, and are sufficiently detailed as to guide staff as to how on a day to day basis the child will be cared for, and his welfare safeguarded and promoted by the home (Regulation 12 (1) (a)) 26/10/2010

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Std. Action Due date

5 review admission processes and the management of accepting emergency admissions (Regulation 4; Schedule 1) 23/11/2010

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Std. Action Due date

1 ensure the Statement of Purpose is accurate, contains all information stated in Schedule 2, is kept under regular review. Ensure the home is operated in accordance with the Statement of Purpose (Regulation 4) 08/11/2010

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Std. Action Due date

30 ensure staffing arrangements ensure that the gender mix of staff on duty is suitable to meet the needs of young people (Regulation 25) 26/10/2010

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Std. Action Due date

31 ensure staff on duty are suitably experienced to fulfil the tasks and roles allocated to them (Regulation 25) 26/10/2010

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Std. Action Due date

33 maintain a record in the form of a register showing in respect of each child who has lived at the home in particular detailing their address prior to being accommodated and the address on leaving the home (Regulation 29 (schedule 4)) 23/11/2010

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Std. Action Due date

34 carry on the home with sufficient care competence and skill, in particular act upon the actions listed in this inspection and in Regulation 33 reports (Regulation 9) 26/10/2010

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Std. Action Due date

34 submit an application for a suitably qualified and experienced 26/10/2010 person to be registered as manager. (Regulation 7)

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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

 review the systems in place to prevent bullying (NMS 18)  review the provision of activities within the home (NMS 15)  ensure information regarding health promotion, children's rights and bullying is freely available (NMS 7)  ensure new staff have supervision every two weeks (NMS 28)  ensure that each member of staff has an annual appraisal (NMS 28.7)  ensure that each member of staff has a personal development plan (NMS 31.4)  ensure staff who are placed in charge of the home have substantial relevant experience and have successfully completed their induction and probationary periods. (NMS 29.3)

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