Children's Home run by Crystal Care Solutions Limited in Stoke-on-Trent

Unique reference number SC358638 Inspection date 15/02/2011 Inspector Rachel Ruth Britten Type of inspection Key

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Date of last inspection 15/09/2010 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 children's home is part of an organisation operated by a private company. The home is registered to care for one young person aged eight to 17 years, with emotional and behavioural difficulties. The home offers opportunities for the young person to develop socially acceptable skills and gain an understanding of independence. The home is a semi-detached house in a residential area and close to local amenities. There is a small mature rear garden and a side driveway which can accommodate three cars.

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Brief description of the service

The young person who was resident in the home on the days of inspection took part in the inspection process.

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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. Three out of five outcome areas are satisfactory because outcomes for individual young people are acceptable and demonstrate care that generally meets their needs. The outcome areas of being healthy and positive contribution are judged as good because the setting is strong and more effective in these areas. Staff are generally well focused on each young person's placement plan and are committed to providing for their home contact, health and educational needs. Staff liaise well with placing authorities and support agencies involved with each young person.

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Summary

However, the setting has a number of shortfalls. These relate mostly to organisation and safety. These shortfalls have limited the success of some recent placements because plans, interventions and behaviour management strategies have not proved successful in engaging young people in making positive relationships and changes to their unsafe behaviours. In addition, the home has retained a place for one young person and accepted other short-term placements under the same offer from one local authority. This situation regarding admissions is not made clear in the Statement of Purpose, leading to potential compromise in decisions about moving to, or leaving, the home.

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Improvements since the last inspection

No recommendations or actions were raised at the last inspection.

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Helping children to be healthy

The kitchen is not locked and it provides a functional dining space for three people to sit, eat and talk together as a family group. Young people recently and presently in placement have made significant gains in their ability to shop, budget, cook and maintain hygiene in the kitchen. Records of what young people eat are kept and fruit is always available for snacks. Staff regularly provide social opportunities for young people to enjoy meals out and takeaways, but are less proactive about teaching young people what healthy eating is and its benefits to their fitness. Staff encourage young people to be physically active. They try to walk rather than go everywhere in the car. Gym and sports club attendance is facilitated.

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Helping children to be healthy

Young people are given good guidance and hygiene routines to help them take control of their bodies and health, for example, regularly showering and cleaning their teeth. Staff do not smoke in front of young people and provide one designated outdoor place for smoking. Each young person has a member of staff identified to support them during the whole two day shift. This staff member provides stability and emotional support, as well as reinforcing the benefits of rest, sleep and cleanliness for health. Young people's individual daily reward scheme may contain aspects relating to personal hygiene and healthy eating too. Careful liaison takes place between all those working with the young person. This helps to ensure a better understanding of particular challenges, such as self-harming behaviour and sexual exploitation, and their impact upon the well-being, behaviour and general health of the young person.

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Helping children to be healthy

Each young person has an individual health record which is part of their case file. Their medical, dental, optical and hearing needs are all met in an organised way, with regular appointments and encouragement to attend. Accidents are properly reported and first aid treatment given by suitably trained staff. First aid supplies and medication are safely stored. However, records do not always show what first aid has been administered. In addition, the contents of first aid boxes and the medicine cabinet are not logged, checked or dates recorded of expiry dates and methods of disposal. This shortfall in monitoring and recording has the potential to adversely affect young people if necessary supplies are lacking, missing, or out of date when they are needed.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy is adequately respected by staff and balanced with their safeguarding needs. They have a key for their own bedroom and can lock the bathroom for privacy when attending to their personal hygiene. Staff always knock and ask permission to come into their room, even if they must enter on agreed safeguarding grounds to prevent or minimise risk of harm to the young person. No surveillance or locks are presently in use to prevent access to communal rooms. Young people enjoy access to free time, phones, computers and electronic games consoles which are agreed as appropriate to their age and safeguarding needs. Safe behaviour is consistently modelled by staff who provide two-to-one care and reinforce house rules which protect everyone. Bullying is not a significant issue because the home accommodates one young person at a time. As a result, the home have omitted to produce and regularly review a written risk assessment of the risks

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Protecting children from harm or neglect and helping them stay safe

Searches of young people's possessions have taken place quite often as a result of risks of self-harming and absconding behaviour. However, clear guidance about when it may be necessary to search young people's possessions is not currently given to young people and they are not signing the records of searches. In addition, a number of searches documented have taken place when young people were not present and records do not make clear what was done with what was found, or how young people were informed about the search. These shortfalls hold back the progress of young people if situations are not used as effectively as possible to engage them in working towards more positive ways of managing their behaviour.

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Protecting children from harm or neglect and helping them stay safe

Young people can regularly have their views heard through the home's questionnaires and house meetings. They all know how to complain if they are unhappy about any aspect of living in the home. Records show that they have used the complaint forms in the home. In their children's guide they have a series of contact numbers and addresses for advocates and organisations, including Ofsted, to whom they can complain. Records show that their complaints are properly addressed and in a timely manner. However, the complaints system does not provide for the recording of informal and verbal complaints and their outcome, for example, from neighbours. Nevertheless, the home has recently adopted a format to include positive comments about the setting. This will allow them to evidence appreciation from other agencies and professionals involved with young people.

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Protecting children from harm or neglect and helping them stay safe

The home is generally effective in protecting young people from abuse. Each young person has the contact numbers for their own local authority social worker and safeguarding unit. The home keeps copies of the safeguarding procedures of each local authority where young people come from. Staff have regular child protection training and good inter-agency links with schools, social care, police and medical professionals, including police-based local projects designed to protect young people who are at risk of sexual exploitation. Young people who are at risk because they frequently abscond, have risk assessments and protocols in place which are regularly reviewed and are designed to minimise and deal with incidents effectively. However, there is evidence that young people have frequently gone missing from the home, including young people at risk of sexual exploitation. Notifications under Schedule 5 of the Children's Homes Regulations 2001 are not always correctly categorised to

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Protecting children from harm or neglect and helping them stay safe

ensure referral to the Local Safeguarding Children Board (LSCB) when there is suspected sexual exploitation. Instead, notification of the incident is made only to the police and young person's social worker. This holds back best inter-agency planning for the young person, centred on child protection concerns. It also detracts from the otherwise good inter-agency work being undertaken to keep young people safe. Young people placed here have complex, significant difficulties associated with entrenched unsafe behaviours, including self-harm, absence without authority, and sexual exploitation. High staff ratios and intensive individualised approaches are designed to help each young person, as are individualised behaviour reward schemes. The latter allow young people to earn extra money for positive activity and behaviour. These are working well for young people newly in placement. However, records of accidents, absences, restraints and sanctions indicate that behaviour

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Protecting children from harm or neglect and helping them stay safe

management approaches are not having consistently good success rates. Some young people have not been able to engage with staff and have disappeared within hours of placement. Others have continued to self-harm or absent themselves and be sexually exploited. Young people seldom engage positively with key workers to review their behaviour when things go wrong. Sanctions are often clearly ineffective. As a result, staff struggle to turn negative incidents into positive outcomes where young people engage and make progress. In addition, management monitoring of the records has not identified and addressed the implications of what the records are showing for the care of individual children and care practice. As a result, some young people's destructive and harmful behaviours are not being reduced because staff are not quickly recognising and acting when different approaches are needed.

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Protecting children from harm or neglect and helping them stay safe

Security is proportionate to essential requirements, such as locking medicines, chemicals and sharp objects away. 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, evacuation drills are regular so that everyone knows what to do and contingency plans are in place for crises, such as sustained power loss or flood. However, some repairs are not promptly made good. For example, the cooker has a panel missing, a light in the bathroom is not working, and towel rails and window coverings are not replaced in the kitchen and bathroom. Outside, the front fence and gate are missing, the door bell does not work, and work on the rear patio flagstones is not complete. Nevertheless, staff cooperate together to ensure that everyone plays their part to keep the home safe and clean for young people during each shift. For example, visitors to the home are properly checked and

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Protecting children from harm or neglect and helping them stay safe

monitored to keep children safe. Similarly, the organisation's recruitment and induction systems ensure that children are cared for by suitable adults.

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Helping children achieve well and enjoy what they do

Young people receive a suitable level of individualised support from committed staff and managers who are consistently available to them across shifts which last two to three days and nights together. This support starts from the moment they are introduced to the home and given their personal copy of the young people's guide. When young people engage in the placement and do not abscond, staff are generally successful to nurture positive relationships with them, despite the fact that many placements are short term or emergency assessment placements.

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Helping children achieve well and enjoy what they do

Prompt and caring efforts are made to find out about young people's likes, dislikes, interests and preferences. Young people are included fully in the life and routines of the home. Individualised therapeutic work is sourced from various local therapists and initiatives if appropriate, to help each young person come to terms with their difficult experiences and family relationships. Personal, health, social and sex education is provided mostly through key worker sessions. However, some young people recently placed have not been able to engage in the individual support made available to them.

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Helping children achieve well and enjoy what they do

Nevertheless, staff are successfully nurturing good quality relationships with young people who are newly in placement. There is a calm household at present where each young person is feeling secure and is participating with increasing confidence. Outings, holidays and individual hobbies are encouraged, including sociable meals out and sporting and gym attendance. Within the home, young people are well occupied, taking part in cooking, choosing films, or undertaking art work.

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Helping children achieve well and enjoy what they do

Good support is given to young people to help them continue or establish full-time education or training. This includes liaison and provision of transport to young people's existing schools. Staff help young people get to school by supporting the achievement of good night and morning routines. They aim to develop trust and competence so that young people can use public transport or walk to get about too. However, despite being ready and enthusiastic to attend school, there is unnecessary delay for new placements in getting into school because agreements to fund travel to existing schools is not resolved promptly enough.

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Helping children make a positive contribution

Young people are placed here for short-term assessment, sometimes on an emergency basis. Staff are efficient and committed, establishing comprehensive placement plans, even when existing information about young people is lacking. All areas of the young person's life are considered in their placement plan, including health, education, culture and individuality, family contact and behaviour. However, these plans do not summarise clearly how the effectiveness of the placement will be assessed. In addition, plans are not made available to young people in an understandable format for them to be able to engage in. All incidents and significant events, positive and negative, are noted and used alongside key worker records to make monthly summaries of each young person's progress. The degree of involvement of young people currently new in placement is good and the staff team take account of their views when selecting key workers.

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Helping children make a positive contribution

Young people are supported well to participate in reviews, meetings and court appearances. Young people are helped to understand the decisions made in meetings; although reports, minutes and records of meetings are sometimes detailed and hard to understand. The home's staff are highly committed to helping children maintain and build their sense of belonging, through family and peer visits, phone and electronic contact. Any restrictions on contact are carefully explained and the issues dealt with sensitively and openly, helping young people to gain appropriate understanding about their past and family situations. Staff accompany children where necessary on long journeys to their home towns, facilitating and supervising contact visits as appropriate.

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Helping children make a positive contribution

Key workers are matched carefully to young people because the aim is that they will be the main adult to whom the young person can develop a real and positive attachment. These relationships are designed to help young people understand what suitable relationships with adults are. The progress of young people recently in placement is variable. Most of them establish good day time routines and attendance at education. Most young people also enjoy the stability of regular contact with appropriate peers and family members. Many young people have developed some useful independence skills. However, some young people have absconded from placement within a few hours and therefore not benefited at all. The progress of others has been limited by continuing unsafe behaviours.

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Helping children make a positive contribution

The short term nature of most placements means that the scope of key worker relationships is necessarily limited. Nevertheless, key staff aim to help each young person make some progress in all the areas of their placement plan. They also aim to assess what their long term needs are and identify the right placement for them. However, some placements have come to an early end because young people are too unsafe in placement.

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Achieving economic wellbeing

Young people receive suitable care which takes into account their age and stage of development. The care provided aims to identify the needs of each young person and help to prepare them for moving to a suitable long term placement. Adults model good parenting and family routines. The daily life of the home provides good opportunities for children to take care of their personal hygiene, their possessions and personal space. The young people presently in placement have already settled into a good routine. Staff encourage young people to save some of their reward monies and help them to exercise age-appropriate choices about what they buy with pocket money. Older young people may also be working towards managing their clothing and food budgets in preparation for independent or supported adult living.

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Achieving economic wellbeing

Young people live in an adequately decorated and appointed home. Furnishings are comfortable, robust and to an adequate standard throughout, although the kitchen and bathroom are outdated. Window coverings are missing in some rooms and decorations are very minimal. However, young people are given opportunities to personalise their rooms and have a say about pictures and articles placed around the home. Staff have recently done some decorating to cheer up the walls in the lounge and bathroom. Staff encourage young people to keep their rooms clean and tidy and to contribute to household chores as part of their individual reward scheme. Some repairs and improvements are slow to be completed which means the environment is less welcoming to young people. For example, there are no towel rails or storage for young people to put their towels and toiletries. Nevertheless there are computers, televisions and games consoles available which young people respect and use with

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Organisation

The young person's guide provides full and personalised information about the home. The Statement of Purpose contains good details and the information about staff and their qualifications is kept up to date. However, it does not make clear the present situation pertaining to admissions to the home, including a retained placement with one local authority. This arrangement is currently influencing all admissions and has implications for the length of some recent placements. There is potential for compromise to young people's individual best interests as a result of this.

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Organisation

Support for staff is mostly well organised and effective, with high quality handover meetings between shifts and good levels of ongoing training. Staff work confidently and openly together and many, including the manager, are undertaking further professional and management training in order to better meet young people's needs as well as minimum standards. Appraisals and supervisions are not taking place on time in all instances, especially when staff are working between more than one home, but the organisation's quality assurance lead person aims to improve the system for this. The manager of the home also aims to monitor supervision more effectively and ensure that the supervisor and supervisee always sign the home's supervision log.

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Organisation

Overall, young people are able to receive sound quality care from committed, adequately skilled and caring staff. There is use of agency and bank staff and the home's staff are sometimes moved between other homes in the organisation. This does not appear to compromise the quality of care offered. Managers are warm and active in the life of the home, providing consistent and competent leadership as well as currently working on shift. This arrangement is kept under review to ensure that it properly supports both quality of care and the efficient, competent organisation of the home. The office and records are organised in systems which all staff understand how to operate and staff morale is good.

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Organisation

Managers are taking steps to improve the timeliness of Regulation 33 visits so that they support the home's own monitoring better and are more effective to flag up weaknesses early. The managers and company strive for excellence, but there is no clear written plan or goals for the home itself.

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Organisation

The promotion of equality and diversity is satisfactory. The care of young people is individualised. Their rooms and case files reflect this. Staff practice in a caring, positive way, finding out about young people's individual interests, preferences and cultural identity.

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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 correctly states the home's current admission criteria (Regulation 4(1) Schedule 1.9) 28/02/2010

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Std. Action Due date

24 ensure that all parts of the children's home used by children are kept reasonably decorated and maintained, in particular the bathroom, kitchen and outdoors. (Regulation 31(2)(e)) 28/02/2010

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s):

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Recommendations

 ensure that all first aid given is recorded and that supplies in first aid boxes and the medicine cabinet are recorded, regularly monitored, replaced and disposed of as appropriate (NMS 13.2)  ensure that young people are given clear guidance on when it may be necessary to search their possessions and that records show whether young people are present, including their signature (NMS 9.8)  ensure that there is a procedure for handling external and informal complaints and that staff know how to record these (NMS 16.4 and 16.6)  ensure that notifications are made to the Local Safeguarding Children Board (LSCB) when there are suspected incidents of involvement in prostitution (NMS 17.5)  ensure that the monitoring of sanctions and restraints addresses the implications for the care of individual children and current care practice (NMS 22.11)  ensure that procedures permitting control and disciplinary measures emphasise

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Recommendations

the need to reinforce positive messages for children to achieve acceptable behaviour and that procedures are based upon establishing positive relationships with children which help them (NMS 22.11)  ensure that recorded and regularly reviewed risk assessments are carried out in relation to the potential for bullying and abuse within the home (NMS 26.2)  ensure that young people's personal education plan is promptly facilitated, including arrangements for travelling to and from school (NMS 14.3 and 14.4)  ensure that placement plans are understood by the young person concerned and that they clearly state the objectives of the placement and how its effectiveness will be measured (NMS 2.1 and 2.6)  ensure that managers have a qualification at level four NVQ in management and in the care of children and young people (NMS 34.3)  ensure that there is consistent and regular supervision for staff, managers and

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Recommendations

agency staff and that the written record kept in the home covers all members of staff and is signed by the staff member and the supervisor (NMS 28.2 and NMS 28.3)  ensure that all staff have their performance individually and formally appraised at least annually by their line manager and that the employee's personal file contains a record of this, showing the level of performance achieved, targets for the coming year and agreed training needs for the coming year as part of the employee's personal development plan (NMS 28.7)  ensure that there is a written development plan for the future of the home, identifying planned changes in the operation or resources of the home. (NMS 33.5)

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