Children's Home run by 4d Care Ltd in Cambridgeshire

Unique reference number SC064557 Inspection date 10/01/2011 Inspector Rachel Ruth Britten Type of inspection Key

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Date of last inspection 07/01/2010 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

This home is a large detached property located in a small village. It is registered to accommodate up to six young people aged between 12 and 18 years with emotional and behavioural difficulties. The home is fully equipped for all aspects of daily living and provides sufficient space for group and separate activities. All young people have their own bedroom. There are two small classrooms in a building on the home’s grounds for the exclusive use of young people living in the home.

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Brief description of the service

Four young people currently live in this home, all of whom were involved in the inspection.

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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

The purpose of this unannounced full key inspection was to reassess all the Every Child Matters outcome areas and to follow up recommendations made at the last inspection visit of 7 January 2010. The home's progress to meet previous shortfalls is satisfactory. Most outcome areas are good and young people receive sound support and care which is suitably tailored to their individual needs. However, there are a number of significant shortfalls relating to staying safe and organisation. As a result the overall quality grading remains satisfactory.

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Improvements since the last inspection

There was one action and two recommendations raised at the last inspection. The action and the first recommendation related to the monitoring of the home. The home's monthly visit on behalf of the provider was not robust enough to meet the regulations and assure the welfare of young people in the home through interviews and checking of the premises and documentation. Similarly, the manager's own monitoring did not assure actions and improvements through the monthly monitoring of records to identify patterns and issues.The second recommendation related to ensuring that the sanction record includes the effectiveness of each sanction.

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Improvements since the last inspection

The home has made satisfactory improvements to rectify both these shortfalls, but further issues are raised following this inspection. The monthly Regulation 33 visiting of the home on behalf of the registered person is taking place in a timely way and contains good detail about the matters monitored. The report format has a place for manager action, but this is not used by the manager and therefore matters raised in the reports are not always acted upon in timely way. For example, health and safety matters and the instigation of monthly staff meetings have taken some months to rectify. There is evidence that the manager is signing many of the home's records on a monthly basis, but there are no notes or reports giving any detail about issues or patterns arising from this monitoring and the action being taken to improve. There is no written development plan identifying planned changes or confirming the current

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Improvements since the last inspection

operation. As a result, a number of shortfalls found at this inspection have not been picked up as part of manager monitoring.

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Improvements since the last inspection

The home has made some improvement to the sanction record. It has been slightly amended to show the outcome of the sanction. However, there are some long- lasting sanctions, including reparation, that are either not logged in the sanction record at all, or do not state the effectiveness of the sanction once it is finished. In addition, a number of entries are made on each page in the sanction record so that the sanctions themselves are not numbered or suitable to use directly with individual young people or copy into their case files. Young people's views and signatures are seldom documented about their sanctions and this is not prompted for on the record sheets. Similarly, there are no prompts on the sanction record for details, such as, the time the sanction was made and who was present at the time. There is also no cross-referencing with any incident, restraint or notification records concerning the

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Improvements since the last inspection

same event to help with monitoring and quality assurance. These shortfalls continue to hold back the effectiveness of records in supporting the high quality of care being provided in the home.

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Helping children to be healthy

Young people enjoy good food and the routine of regular sociable mealtimes together around the dining table. They help to choose menus at their weekly young people's meeting and records adequately show where and what individual young people have actually eaten. Some young people regularly participate in the weekly shop and assist with cooking and baking alongside staff. This enhances their independence skills and understanding of budgeting and catering for larger numbers. Others participate in gardening and growing some of the vegetables used in the cooking. Young people and staff add favourite recipes from home to the menu so that their individual family cultures are more valued and understood by the group. The home's ethos is to keep convenience foods and additives to a minimum and to talk to young people consistently about the benefits to health and well-being of eating a balanced diet. Young people's physical and emotional health benefits from

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Helping children to be healthy

staff's positive input for healthy lifestyles.

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Helping children to be healthy

Young people have their health needs clearly identified and are given well organised and sensitive support to attend all necessary appointments. Staff use regularly reviewed health assessments and health plans which take into account young people's background, developmental age and risky behaviour. The plans incorporate simple, measureable goals for the young person's physical and mental health, focussing the daily encouragement, guidance and advice which staff give. Staff also actively discourage smoking and drug use, providing a positive role model and engaging young people in healthy active pastimes. Good personal hygiene routines are promoted well by staff, so that young people take pride in themselves and their image. The home enlists the support of specialist helpers in relation to mental health and substance misuse where appropriate. All this ensures that young people's health needs are met well. Staff are trained in first aid and administer medications safely.

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Helping children to be healthy

However, the new system for recording accidents and illnesses on individual files is more difficult to monitor for trends and is not yet being used consistently. Medication records do not presently prompt staff to note when the medicine expired and how it is actually disposed of. These shortfalls have not adversely affected any young person to date.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy is well respected and staff are seen to treat each individual with proper respect. Young people know how to complain and the home's procedures are suitable and generally effective in safeguarding young people. They include regular child protection training for staff and routine interagency links with schools, social care and medical professionals. Robust action is taken, in accordance with Local Safeguarding Children Board procedures and Children's Homes Regulations, when there are allegations against staff. Each young person has a detailed placement plan and risk assessments which detail appropriately how their rights to family contact, use of the telephone, supervision and privacy are balanced with the need to safeguard them, and those around them, from harm. All staff know and operate within these parameters so that young people are consistently protected. However, due to recent concerns about possible smoking and drug use,

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Protecting children from harm or neglect and helping them stay safe

young people have been informed that it may be necessary to search their possessions. No clear guidance has been given to young people about the grounds for, and conduct of, searches. This has the potential to undermine their right to privacy if searches do not meet the relevant national minimum standard.

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Protecting children from harm or neglect and helping them stay safe

Young people are living in an atmosphere where bullying is known to be unacceptable. The issue is always raised in weekly young people's meetings and staff are observed to deal effectively with every instance as it arises, through prompt and positive discussions, perhaps over meals. Young people's individual risk assessments regularly review their potential to bully and be bullied. Young people receive one-to- one support from staff and are being satisfactorily assisted to develop acceptable behaviour through constructive praise and individual daily rewards. Young people who are absent without authority are protected in accordance with their risk assessment and care plan. They are responded to positively when they make contact and return. Sanctions and restraints are not unreasonable and the home's training and ethos stresses the importance of positive role modelling, reparation and de- escalation strategies wherever possible.

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Protecting children from harm or neglect and helping them stay safe

Young people say that the behaviour management rules of the home are fair, but some young people continue to struggle to conform to these. They seldom give their views or sign sanction, incident or restraint logs as part of their individual learning and development. This is a missed opportunity to learn and make progress following incidents, particularly when there has been a long period of reparation to repay a contribution for damages caused. In addition, records have not been completed in every case and they are not all in a format where they can be easily copied for individual files or cross-referenced for monitoring purposes. Record books also lack some required detail. For example, restraint records do not prompt for staff to log whether a young person has been offered medical attention. These shortfalls reduce the effective use of behaviour management records by staff and managers to identify

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Protecting children from harm or neglect and helping them stay safe

and provide the right support for each young person.

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Protecting children from harm or neglect and helping them stay safe

The home provides adequate physical safety and security to young people. Training, procedures and checks ensure that the building and utilities are safe and adequate for purpose, both day-to-day and in the event of an emergency. For example, fire evacuations, food storage and monitoring, safe storage of chemical products, and young people's individual risk assessments, are all good. A curling mat in the hall is secured down promptly so that no one can trip over it, but the storage of knives is not suitable and broken glass outside has not been removed, despite reporting by the Regulation 33 visitor some three months ago. This indicates that the current reviewing of generic risk assessments and action plans following monitoring are not effective enough to support safety well.

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Protecting children from harm or neglect and helping them stay safe

There is a consistent staff group providing care to young people. Staff do not start work until the vetting process is completed. Visitors to the home are properly checked and monitored to keep young people safe. Managers and staff use the notification system correctly to ensure that the appropriate agencies are informed about events. For example, all staff know that Ofsted must be notified of the instigation of any child protection investigation. Staff files show some detail about qualifications and vetting, but not all files contain a recent photo and explanation of any gaps in employment as required by Schedule 2 of the Children's Homes Regulations. In addition, some details about drivers' insurance and license is out of date. This has not adversely affected young people's safety, but the home's own monitoring systems have not identified these shortfalls.

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Helping children achieve well and enjoy what they do

Young people receive a good level of individualised support from committed staff and managers who are consistently available to them and work successfully to nurture positive relationships with them. Access to personal, health, social and sex education is mostly provided through key-working sessions, with some referral to specialist professionals where appropriate, including the youth offending team, play therapists and psychologists. Staff actively try to include each young people in the social group of the home and give them trust and responsibility, for example, through weekly meetings, group mealtimes and night-time hunts in the dark. Special occasions, such as bonfire night, are enthusiastically planned and are successful in including past residents and families alongside young people. They are greatly enjoyed by all. Staff also support young people in developing social and independence skills. These

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Helping children achieve well and enjoy what they do

include using public transport, participating and attending sports events and community activities, and meeting local friends. Particular success is being achieved presently with every young person attending education, either at the education unit or in local education and work placements. This is very valuable to each young person in improving their chances as adults. Each young person's personal education plan is up-to-date and staff are giving very positive feedback and rewards to young people for establishing a work routine and committing to their studies. Active, character-building leisure activities are provided as well as opportunities to go shopping or to the cinema or skating. For example, young people frequently undertake outdoor walking and camping expeditions and challenges, through which they strengthen their relationships, physical stamina and ability, and self-esteem. Young people have learned to overcome their fear of the

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Helping children achieve well and enjoy what they do

dark and have enjoyed the thrill of a flight in a light aircraft. There is a good balance between group and individual outings and between home-based and outdoor free time. This is based upon each young person's risk assessment. For example, different young people enjoy using the games console, mixing music in their room, making favourite cakes, washing the cars, going night fishing, or attending football matches. Young people are well settled and are developing confidence and improving social skills.

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Helping children make a positive contribution

Young people are appropriately placed and their needs are being assessed and met well in the home. Their placement plans contain simple clear short and medium term plans which key workers copy for young people and go through individually with them to help clarify their goals. Similarly, detailed 24 hour plans detail each young person's routines, objectives and the expected support and input of staff. This ensures that everyone knows what they are trying to achieve with each young person and the reasons for this. As a result, staff are working meaningfully and proactively on each shift to make it count for each young person's well-being and progress. Detailed weekly logs are made for each young person, indicating what has happened. These logs are typed and used by key workers both to keep placing social workers informed and to provide a basis for targeted work with young people about what is going well and what is going less well. Young people are engaged to differing

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Helping children make a positive contribution

degrees with their plans, but the stability of placements and the confidence of young people in the setting indicates that their needs are met well.

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Helping children make a positive contribution

Young people are supported well to participate in reviews and express their feelings and views. Preparation for meetings is good. The home proactively arranges them at the home venue and prompts placing authorities to maintain regular visits and come to meetings, including arranging extra meetings if emergencies arise. Key workers encourage young people to voice their views and comments, but often these are not documented on their records because young people are still reluctant to view and contribute to their files. Staff also work hard to facilitate constructive contact between young people and their families, where this is safe for the young person. Shifts are flexible to provide for travel, supervision and support, so that young people's family relationships are promoted. In addition, young people benefit because their families have confidence in the staff. Families see the support that their child is receiving and the progress they are making and are more prepared to

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Helping children make a positive contribution

The present group of young people in the home is stable and quite long standing. Young people can refer to the notice board or minutes of their meetings for current issues. Staff are genuinely interested in hearing young people's views and facilitate wide-ranging discussions, for example at the meal table. They take each one's cultural background, developmental stage and interests into account and help them to learn to listen to, and consider, one another. Staff maintain respectful and caring relationships with young people which are honest and based upon high expectations of what they can achieve. Managers consider any new referrals carefully and prioritise the needs of the current group. Any decisions about admissions take all young people's views into account. However, the home does not use regularly reviewed risk assessments to document the likely effects of new admissions on the present group. This has not adversely affected young people because careful

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Helping children make a positive contribution

consideration is given to placements in practice. No recent admissions have taken place because none have been compatible with the needs of the young people presently placed.

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Achieving economic wellbeing

Young people receive care which takes into account their stage of development and helps to prepare them for adulthood. For example, the daily life of the home provides opportunities for them to take care of their personal hygiene, their possessions and personal space, and increasingly of their own money. Staff also work with young people to help them develop self-esteem, positive relationships and sustainable work and leisure routines. This includes taking responsibility for the consequences of any damage that they cause. Staff help young people to exercise good choices about what they buy, clothes and items relating to religions and cultures which they are interested in. They also sometimes supervise all their spending as a sanction if it has been spent on illegal substances. Reward monies may be earned in addition to pocket money and allowances, motivating young people to engage more. Continuing informal support is given to young people who have moved on to independence

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Achieving economic wellbeing

locally. In addition, ways are sought alongside placing authorities to provide ongoing support to young people who will not be able to achieve complete independence in the community.

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Achieving economic wellbeing

Young people enjoy a specious, well maintained home. Living in a pleasant environment helps them to feel valued. Furnishings are comfortable and to a generally high standard in all shared areas. Young people's bathrooms are large and very well appointed, as are their bedrooms. There are desk or table facilities in the bedrooms for young people to study quietly. The home is kept very clean and tidy and there are good computers, televisions and games consoles to use. Most young people have their own phones. They can make safe use of these as well as the internet and social networking sites according to agreed risk management. In some instances young people have agreed restrictions in place to secure their safety in respect of these.

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Organisation

The home's Statement of Purpose and the young person's guide provide information about the home and these are reviewed. However, the Statement of Purpose does not provide the number, qualifications and experience of all the staff working at the home. The absence of this information means that placing social workers know insufficient information about the staff at the home. The children's guide is adequate, but some of the information and guidance which young people need is not put into it and some photos are out of date. The impact of this is currently minimal as there are no young people coming into placement.

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Organisation

Support for staff is satisfactory in the home. Rotas work well to provide good staff levels and consistency of care which benefits young people and staff morale. Young people know who is looking after them on each shift and shift leaders complete a weekly prompt task sheet to ensure that all matters are covered as required. There are sufficient qualified staff who take care to read handover notes. Staff understand the disciplinary procedure and their responsibilities. They provide positive role models to young people. These factors promote good organisation and a team spirit on every shift. However, staff meetings are not taking place monthly and the most recent agenda and minutes do not indicate that the meeting talked about the home's work in caring for individual children and the management of the current group.

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Organisation

Staff receive regular training in all areas of the care of children and are competent about child protection, fire, first aid and medication administration. Their induction training is suitable and ongoing on-line training resources are used in conjunction with in-house training, for example, in positive behaviour management. Staff discuss matters arising with the team and understand reporting lines. However, staff are not enrolling and completing professional training within required timescales. In addition, supervision and appraisal sessions are not regular enough to meet timescale requirements in all cases. These shortfalls have the potential to adversely affect staff morale and standards of care. However, staff report that team working and the atmosphere in the home are 'healthy and positive' at present. Staff say that they feel 'fired up' by their success in helping young people to make progress.

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Organisation

The home receives monthly monitoring visits which helps to drive continuous improvement. The reports of these visits are accompanied by a letter and a place for the manager to construct an action plan. However, this tool is not used and the monthly management monitoring does not promote prompt action on all matters noted in Regulation 33 reports. In addition, various shortfalls in recording have not been identified until inspection. These have the potential to reduce the effectiveness of work with individual young people.

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Organisation

The promotion of equality and diversity is good. The care of young people is individualised and case files reflect this clearly. Key working is effective and of good quality. All staff know and work to young people's individual objectives, care plans, risk assessments and behaviour management plans. Staff practice in a caring, positive way, listening and valuing each individual young person's differences. They support young people's individual interests and preferences and help them to balance these with conformity to basic social rules for life.

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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

1 ensure that the Statement of Purpose contains all the matters required in Schedule 1, in particular, the number, qualifications and experience of the staff working at the home (Regulation 4 (1), Schedule 1.5) 12/02/2011

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Std. Action Due date

26 ensure that unnecessary risks to the safety of children in the home are identified and so far as possible eliminated, in particular the storage of knives and the broken glass in the grounds (Regulation 23 (c)) 12/02/2011

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Std. Action Due date

27 provide all the information required in Schedule 2 in respect of persons working at a children's home, in particular, proof of identity, including a recent photograph and satisfactory written explanation of any gaps in employment (Regulation 26 (3)(d)) 12/02/2011

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Std. Action Due date

28 ensure that all persons employed receive appropriate training, supervision and appraisal. (Regulation 27(4)(a)) 12/02/2011

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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 medication records include details of when medication ceases or expires and how it is disposed of (NMS 13.2)  provide guidance for staff and young people on when it may be necessary to search their possessions (NMS 9.8)  ensure that all sanctions are logged and that the record includes the names of people present, time, location and sanction number (NMS 22.10)  ensure that where there has been physical intervention, the young person has the right to be examined by a medical practitioner or nurse within 24 hours (NMS 22.13)  when disciplinary measures (including sanctions) are used, ensure that young people are encouraged to write or have their views recorded and sign their names against them if possible, in records kept by the home (NMS 22.14)  ensure that the Schedule 6 monitoring system effectively identifies issues and prompts timely actions to improve and adjust the home and ensure that

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Recommendations

monitoring contributes to the home's written development plan which identifies planned changes or confirms continuation of the home's current operation (NMS 33.1 and 33.5).

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