Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

Unique reference number SC033268 Inspection date 01/11/2010 Inspector Graham Robinson Type of inspection Key

p.1

Date of last inspection 23/03/2010 Website: www.ofsted.gov.uk

p.1

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.

p.2

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

p.2

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.

p.3

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.

p.3

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

p.3

Brief description of the service

This 12 bedded children's home is one of three run by the company. The home is in a small village with a purpose-built school also on site. It is a detached house with its own extensive grounds. The home has access to a range of local facilities in a nearby town.

p.4

Brief description of the service

It is registered for 12 young people, aged from six years to 12 years, of either gender, with emotional and behavioural problems. There are currently 10 young people on roll. Most young people have a statement of special educational needs, which provides for their additional needs.

p.4

Summary

The overall quality rating is satisfactory.

p.4

Summary

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

p.4

Summary

At this unannounced, full inspection all the key standards were inspected. Any outstanding actions and recommendations made previously were also followed up.

p.4

Summary

The home and staff have experienced a difficult year having had to cope with a number of issues that has impacted on the management of the home and parts of its operation. However, staff have pulled together and work collectively to promote the safety, welfare and outcomes for young people. The promotion of equality and diversity is good throughout the standards inspected.

p.4

Summary

The home accommodates a young group who are reliant on staff. Young people speak positively about the home and staff, raising no issues, concerns or complaints during the inspection. Their needs are identified with plans and strategies in place to meet them.

p.4

Summary

The report contains two actions that have been carried over from a recent investigation conducted by Ofsted. No new actions have been made as a result of this inspection. Five new recommendations have been made linked to recording and a number of management issues.

p.4

Summary

The overall quality rating remains as satisfactory, although progress has been achieved in being healthy, which has been judged as outstanding.

p.4

Improvements since the last inspection

Three actions were made following the previous inspection and each one has been addressed positively. This has led to improvement into the presentation, content and layout of the central records which record areas such as bullying, complaints and safeguarding. All risk assessments of the building are now being reviewed and where necessary, updated on an annual basis.

p.4

Improvements since the last inspection

Four recommendations were also made, three linked to issues around privacy and one around the reviewing of sanctions to test their effectiveness. Improvements have been made in the handling of private information along with updated guidance and practice for staff when bathing young people.

p.5

Improvements since the last inspection

A recommendation around privacy locks for bedrooms doors has been removed as the current arrangements are deemed acceptable for the group of young people currently accommodated. However, it is an area that will be re-assessed at future inspections.

p.5

Improvements since the last inspection

The format for recording sanctions has been amended, with a specific section introduced into the records that requires staff to review and make a judgement around the use and effectiveness of the sanction imposed.

p.5

Helping children to be healthy

The arrangements to promote the health needs of young people are outstanding. The home employs a part-time nurse who oversees and co-ordinates the health needs of young people effectively. Excellent links are maintained with local providers, enabling young people to be registered and receive a full package of community based medical care.

p.5

Helping children to be healthy

The home has developed links and has access to a range of specialist medical services and resources, who provide regular, specialist medical input. For example, clinical child psychologist, psychiatrist, psychotherapist, speech and language therapy along with others. Excellent links allow the home to regularly access specialist services supplied by the health authority.

p.5

Helping children to be healthy

Health planning and promotion is highly effective. Young people have their health needs assessed, which are reflected in the health and health promotion plans in place for each young person. These are supplemented by specific health files compiled and held by the nurse.

p.5

Helping children to be healthy

Appropriate arrangements are in place to store and administer prescribed and non- prescribed medication. This is underpinned with comprehensive systems to record the administering of all medication. Written consents for young people to receive a full range of medical treatments are in place. Staff receive training in the administering of medication and first aid.

p.5

Helping children to be healthy

Young people confirm they are consulted and make choices regarding the range of food served, giving young people's meetings as an example. Menus are balanced to take account of healthy eating and the choices made by young people. Meals are used as social occasions and taken in a pleasant dining area. Young people raised no issues or concerns regarding the quantity, quality and choice of food served.

p.5

Protecting children from harm or neglect and helping them stay safe

Privacy is not an issue of concern to young people. Bedrooms are single occupancy and although individual privacy locks have not been fitted, doors can be locked by staff when bedrooms are not in use. Staff were observed knocking on bedroom doors and checking with young people prior to entering bedrooms. All sensitive information is stored securely in offices used by staff.

p.6

Protecting children from harm or neglect and helping them stay safe

Young people understand how to access the complaints system, which is underpinned with written information provided for them. Young people say they can approach staff to voice opinions and any concerns they may have, feeling they will be listened to. Appropriate systems to record complaints are in place, which also details the outcome of any complaint received. The home has its own independent listener, with contact details displayed in the home and reflected in the young person's guide. This, and a worries and suggestion box located in a corridor are additional ways for young people to make complaints.

p.6

Protecting children from harm or neglect and helping them stay safe

The safety and rights of both young people and staff are protected. Staff are trained to respond and deal appropriately with any safeguarding issues that may arise. Good links are in place with the external services and agencies specifically charged to deal with safeguarding matters. All incidents have been dealt with appropriately with immediate external referrals being made. Senior staff meet regularly to monitor and assess safeguarding issues and referrals.

p.6

Protecting children from harm or neglect and helping them stay safe

None of the young people raised any concerns about bullying, saying that staff will not tolerate bullying and act quickly if a situation arises. The home maintains a bullying log that details any incident and the log is monitored regularly. Good staffing levels and deployment around the home go some way to eliminating opportunities for bullying to occur.

p.6

Protecting children from harm or neglect and helping them stay safe

Staff understand what they should do if a young person goes missing and systems are implemented should this occur. Whilst there have been some recent incidents of young people absenting themselves for relatively short periods, young people are not actively going missing without authority with the intention of running away. Appropriate records are maintained of any incident of unauthorised absence, although some discrepancy in the detail of when they return, has been identified.

p.6

Protecting children from harm or neglect and helping them stay safe

The young people accommodated can be spontaneous, disruptive, challenging and at times, violent, which makes behaviour management a key area. However, the home is relatively stable and any flashpoint or incident is dealt with effectively by staff without having a major impact on the home's organisation or management. Staff are skilled at dealing with incidents, which are dealt with calmly and professionally and in such a way that allows all parties to move on quickly. The home continues to look at and reflect on how it manages rewards and sanctions. For example, the records of sanctions are now known as actions and consequences, with a specific section inserted that requires any sanction imposed to be reviewed and judged on its effectiveness. Young people speak positively about the points system recognising that they are rewarded for good behaviour.

p.6

Protecting children from harm or neglect and helping them stay safe

All staff are trained in appropriate positive handling techniques that are refreshed regularly. Written records of any sanctions and incidents of physical intervention are available, along with evidence of management oversight. Young people raised no issues or concerns about any matter linked to behaviour management, with a number stating that they feel safe and that staff are fair.

p.7

Protecting children from harm or neglect and helping them stay safe

General health and safety issues are addressed by a range of risk assessments identifying hazards both in and away from the home. This includes a specific, up-to- date fire risk assessment. Young people are familiar with fire procedures, taking part in regular fire drills. Appropriate service and maintenance contracts are in place.

p.7

Protecting children from harm or neglect and helping them stay safe

All staff are checked prior to taking up their duties in the home. There is a policy, underpinned by practice to re-check staff every three years, which is viewed as good practice. Recruitment procedures are comprehensive and meet with current statutory requirement and recognised good practice.

p.7

Protecting children from harm or neglect and helping them stay safe

At a recent investigation undertaken by Ofsted, some shortfall was detected regarding the arrangements around agency staff. This shortfall is reflected in the two actions that appear in this report. They are carried over from the original investigation as the home had not had the opportunity to address these issues.

p.7

Helping children achieve well and enjoy what they do

Young people receive high levels of individual support. Good staffing levels allow for individual plans to be formulated and needs to be met. This is evidenced in a series of planning documents, individual risk assessments, records of house tutor sessions and the daily recording undertaken on each young person. Young people recognise the support they receive, speaking positively about staff in general and their own house tutor.

p.7

Helping children achieve well and enjoy what they do

The home often accommodates young people with a history of rejecting formal education. Despite this, the ethos of the home is to promote and support young people in their education. All young people are in full time education, attending the on-site school which is registered with the Department for Education. They speak positively about the school and evidence is available that charts the progress and achievements made by young people.

p.7

Helping children achieve well and enjoy what they do

Young people's individual needs, interests and choices influence the range of leisure activities taking place. Staff are skilled at encouraging and coaxing young people into trying out new experiences. Good access to transport, aligned with good staffing levels, allows for a mix of both communal and individual activities to take place. For example, the programme of activities implemented during the recent summer and half term break, show a mix of community-based activities designed to meet both individual and group needs.

p.7

Helping children make a positive contribution

The home produces a range of documentation such as action plans and review reports, along with specific health and contact plans, that make up the planning documentation. When read collectively, they provide a good insight into the individual needs of a young person and the plans and strategies in place to address them. This includes any specific religious, cultural and racial needs a young person may have.

p.8

Helping children make a positive contribution

Statutory reviews are taking place regularly, within the required timescale. The home is producing high quality, comprehensive reports charting the progress of young people, prior to a statutory review taking place. Young people confirm they are supported to attend their own review.

p.8

Helping children make a positive contribution

Contact arrangements for some young people can be limiting and complex, due in part to safety reasons. Specific contact details and records form a section of a young person's case file and integrates into planning documentation. Young people are well informed and understand why their own arrangements can at times, be complex and limiting.

p.8

Helping children make a positive contribution

The admission and discharge procedures are well practised and young people speak positively about how they were received and supported when first admitted. Staff understand the procedures which are woven into the working practices of the home, whilst recognising the difficulties and stresses a young person has at these times.

p.8

Helping children make a positive contribution

There are good systems in place that allow for meaningful consultation, with young people giving house tutor sessions and young people's meetings as examples of where consultation takes place. This is underpinned by constant, ongoing communication between staff and young people. Young people are at ease in the company of staff and the relationships between the two parties was observed as good.

p.8

Achieving economic wellbeing

The age range of the young people accommodated means that preparation for leaving care is not applicable. However, staff are experienced at preparing young people to move into other placements, particularly foster care. Within the home, young people are encouraged to develop skills that assist towards greater independence such as chores around the home and helping others.

p.8

Achieving economic wellbeing

Work to re-wire the home has only just been completed and a programme of repair and decoration commences the week following the inspection. This programme includes a number of bedrooms occupied by young people.

p.9

Achieving economic wellbeing

Despite the scarring to parts of the home due to the recent work, the general state of repair, décor, fixtures, fittings and furnishings is good. The home has its own people who initiate repairs quickly and to generally maintain the building and grounds.

p.9

Achieving economic wellbeing

All bedrooms currently occupied by young people are single occupancy and are personalised to reflect the interests of the occupant. Young people have a range of personal effects, belongings and toys in their rooms, which make them look lived in. Bathrooms are modern, with a choice of shower and bath available. There are working privacy locks fitted to the doors of each bathing and toilet facility used by young people.

p.9

Achieving economic wellbeing

Young people say they like the building and the environment they live in and were observed as being relaxed and comfortable within their surroundings. The home is spacious with a number of rooms available on the ground floor where young people can spread out and play, or follow their own interests and hobbies.

p.9

Organisation

Both the Statement of Purpose and young people's guide meet with regulatory requirements and provide an accurate insight into the functioning of the home. The young person's guide is produced in a child-friendly way and provides relevant information, in an age appropriate format, about life in the home.

p.9

Organisation

The promotion of equality and diversity is good. Along with the planning documentation that provides a good recognition of individual needs, the home's ethos and working practices are designed to promote equality and diversity issues, positively. For example, specific equality and diversity training for staff is ongoing and staff were observed working in a non-judgemental way, which allowed young people to move on quickly if they had been involved in an incident or got into trouble.

p.9

Organisation

The Registered Manager has been away from the home long-term and her prolonged absence has impacted into some of the organisational and management tasks. For example, with the formal supervision programme, the use and implementation of personal development plans and with the general oversight and implementation of staff training. Senior staff at the home recognise and acknowledge the problems, despite having put temporary contingency plans into place. However, the current situation regarding the permanent post of Registered Manager, is a problematic area that is unresolved. An experienced and well qualified staff team generally feel well supported and are working collectively to improve standards and outcomes for young people. Staff morale is reported to be improving following a difficult period in the history of the home and this was reflected in the observations made and conversations undertaken with staff during the inspection.

p.9

Organisation

Currently, a staff recruitment exercise is ongoing with the intention to replace staff who have left and to increase numbers of staff in permanent posts. It is the intention that once in post, there should be no immediate necessity for the use of agency staff.

p.10

Organisation

Both the internal and external monitoring of the home are taking place consistently, within the required timescale. Reports are produced monthly and contain areas for action and an element of quality assurance.

p.10

Organisation

Young people's case files are neat, tidy, well ordered and up to date.

p.10

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.

p.10

Std. Action Due date

28 ensure that all staff, including agency staff, have the qualifications, skills and experience necessary to safeguard and promote the welfare of children resident in the home. This includes a detailed and recorded induction programme outlining among other things health and safety matters and safe caring arrangements (Regulation 27) 26/11/2010

p.10

Std. Action Due date

31 ensure that for all staff the home has a record detailing the requirements of Schedule 2 of the Regulations. For agency staff this might include written confirmation that the agency has obtained the necessary details and provided this detail to the home. (Regulation 27) 26/11/2010

p.10

Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s):  ensure the central log recording unauthorised absence includes the date of return (NMS 19.6)  ensure the formal supervision programme is implemented with more consistency and follows the timescale laid out in the standards (NMS 28.2)  improve management input and oversight for identifying, implementing and recording the training needs of staff and the expectations regarding training, as laid out in this standard (NMS 31.4)  develop the personal development plan format used for staff further, along with its practical use, to ensure it meets the needs of staff (NMS 31.4)  review the current situation regarding the post of Registered Manager with a view to introducing more permanent arrangements. (NMS 34)

p.10