Children's Home run by Care Afloat Ltd in Lancashire

Unique reference number SC006013 Inspection date 14/02/2011 Inspector Sharon Lloyd Type of inspection Random

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Date of last inspection 14/10/2010 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 a three bedroom semi-detached house with a garden that provides domestic style accommodation. It is owned and operated by a private provider. It provides care and accommodation for one child or young person between the ages of eight and 17 years.

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Brief description of the service

Accommodation is provided over two floors. To the lower floor there is a lounge and a kitchen that includes a dining area. Upstairs, there is one large bedroom for a child or young person and two small bedrooms for staff. One of the staff bedrooms doubles as an office. Staff use the same bathroom as children and young people.

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Brief description of the service

One young person lives at the home and participated in the inspection.

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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 unannounced inspection focused on the outcome area staying safe and the recommendations made at the last inspection. Additionally, shortfalls in support to young people and in promoting their good health were noted and are commented upon.

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Summary

There has been a significant drop in the home's ability to keep young people safe and to promote their health and well-being. Two actions are required and four recommendations for good practice are made because the home is not ensuring that young people receive adequate amounts of food and is not promoting their safety appropriately. A recommendation is made in relation to the home's poor response to professional guidance regarding behaviour management and support to young people.

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Summary

Four further actions are required. These relate to the organisation and management of the home. Shortfalls identified at the last inspection remain outstanding. The home is not monitored effectively by the Registered Manager and young people are looked after by staff who are not appropriately supervised and supported so that the level of care they provide is less than satisfactory.

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Improvements since the last inspection

There were four recommendations for good practice made following the last inspection. Two related to the safe administration of medicines. The recommendation to report any frequent refusal to take medication to the prescribing practitioner has not been actioned. The recommendation to assess whether young people are sufficiently responsible to self-medicate has been addressed; however, assessments are not reviewed when young people do not take appropriate responsibility for medications prescribed. This compromises young people's health and well-being.

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Improvements since the last inspection

Two recommendations from the last inspection relate to the organisation of the home. A recommendation to demonstrate that action is taken to address shortfalls identified through quality assurance processes has been partially met. However, a lack of management oversight has resulted in ineffective monitoring of the delivery of care to young people. Action is required to address this. The recommendation to ensure that staff receive regular one-to-one supervision remains outstanding. This means that young people are cared for by staff who are inadequately supported and supervised. Action is required.

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Helping children to be healthy

Staff have not been adequately trained to support young people who are preparing to leave care. Young people receive limited and restrictive support. The arrangements for planning, purchasing and preparing food are poor and young people report they are hungry because they do not manage their budgets effectively. Locks on the kitchen door and kitchen cabinets prevent young people from accessing food they have not bought from their budget of £25 a week. This means young people are not receiving an adequate amount of food and some young people have lost weight as a result. Sanctions records show that a young person was charged £11 for breaking into a cupboard and eating food he had not bought. Young people report they have had no food at the home for up to three days.

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Protecting children from harm or neglect and helping them stay safe

Staff are aware of the importance of promoting the privacy and confidentiality of young people and all documentation is securely stored; however, young people report there is inconsistent practice in terms of staff knocking before entering their bedroom and they feel some staff do not adequately respect their privacy.

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Protecting children from harm or neglect and helping them stay safe

There is a policy in place for undertaking room searches pertaining to the individual needs of young people; this is not consistently followed and this detrimentally impacts on the quality of care and supervision of young people.

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Protecting children from harm or neglect and helping them stay safe

Young people know how to make a complaint and have received written information about the complaints process. There have been no complaints since the last inspection. Young people are invited to meet with the staff team to discuss matters of concern but usually decline. Young people raised a number of concerns with inspectors that had not been raised with the staff. Young people expressed that they felt powerless to influence decisions made by the home and the placing authority. Staff know how to respond appropriately in the event of a young person making an allegation against staff or a disclosure of abuse. This ensures that young people are protected from abuse by the good safeguarding procedures at the home. Young people are made aware of the home's 'no bullying' policy and risk assessments relating to bullying guide staff in how to respond, should it occur.

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Protecting children from harm or neglect and helping them stay safe

Young people who are absent from home without permission are safeguarded in line with written protocols. Staff have a clear understanding of the procedures to follow during such an incident and all information is recorded effectively. On their return, staff routinely offer young people the opportunity to meet with an independent person to discuss the reason for their absence so that any matters raised can be addressed. Young people report they prefer to speak to staff and do not need to speak to an independent person.

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Protecting children from harm or neglect and helping them stay safe

Staff receive guidance and training in positive behaviour management strategies. They use incentive schemes as well as sanctions to help young people develop self control and appropriate social skills. Recordings of sanctions and physical interventions are up to date. Restraint is not used when only one member of staff is on duty. Although the documentation is in place, there is a distinct lack of review to ensure the changing needs of young people are met. There is limited engagement of young people in house meetings resulting in them having little awareness of their rights and responsibilities. The support provided to young people preparing for independent living is restrictive and lacks inclusivity, which isolates young people from positive interaction with staff.

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Protecting children from harm or neglect and helping them stay safe

Risk assessments relating to young people's known and likely activities are insufficiently robust and there is little evidence of review. This means they do not adequately serve to guide staff in how to respond to hazardous situations. For example, the basis for reducing staffing levels to one-to-one is not sound and the risk assessment does not consider the safety of young people and staff at night.

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Protecting children from harm or neglect and helping them stay safe

Staff carry out regular health and safety checks to ensure the home provides a safe environment for young people to live. Routine checks on services and equipment are completed by appropriate professionals and any identified shortfalls are addressed. However, the home cannot evidence that it routinely carries out fire safety checks because there are no records of these checks since December 2010.

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Protecting children from harm or neglect and helping them stay safe

Staff recruitment records were not available at this inspection so vetting procedures could not be verified. Staff are aware of the induction process and described safe recruitment of staff through Criminal Records Bureau and reference checks. Young people are protected as far as possible from coming into contact with potential abusers by the recording and close supervision of visitors.

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Helping children achieve well and enjoy what they do

Although young people are appropriately referred for professional assessment and support, recommendations made in reports by health professionals are not always taken into account and followed. This means that young people do not get high quality care and behaviour management in accordance with their identified needs.

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Helping children achieve well and enjoy what they do

Young people who have finished formal education are encouraged and supported to attend college or participate in apprenticeship schemes, which they do successfully.

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Organisation

The management of the home is unsatisfactory. The manager also has responsibility for another service within the company and spends little time at this home. The young person said the manager 'is never, ever, ever here'. Whilst this is clearly an exaggeration, records demonstrate that the manager is not in full-time day-to-day charge of the home. Responsibility for reports that demonstrate monitoring of the quality of care provided is delegated to a member of staff who is not qualified to fulfil this role. There is no evidence that practices are reviewed and improved as a result of this quality assurance procedure.

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Organisation

Staff team meetings and one-to-one supervision meetings are infrequent so that staff do not receive the support and guidance they need to meet young people's needs. Care practices are not appropriately discussed and reviewed and this results in young people receiving a less than satisfactory level of care.

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Organisation

Recommendations made following the last report relating to shortfalls in quality assurance processes and staff supervision have not been adequately addressed.

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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

10 ensure that with immediate effect young people are provided with food in adequate quantities and at appropriate intervals that is properly prepared, wholesome and suitable for their needs and preferences (Regulation 13 (1)) 16/02/2011

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Std. Action Due date

26 ensure that unneccesary risks to the health and safety of young people are identified and so far as possible eliminated. This means you must ensure that the safety of young people who finish work late at night is promoted and that locks on the kitchen doors are removed so that young peole who are hungry can access food (Regulation 23 (c)) 16/02/2011

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Std. Action Due date

30 ensure that there is at all times and with immediate effect, having regard to the need to safeguard and promote the health and welfare of young people acommodated in the home, a sufficient number of suitably qualified, competent and experienced persons working at the home so that young people who need assistance at night receive it (Regulation 25 (1)) 16/02/2011

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Std. Action Due date

28 ensure that all staff receive appropriate training and supervision so that they sare suitable to meet the needs of the young people accommodated (Regulation 27 (4)) 28/02/2011

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Std. Action Due date

33 ensure that the registered person establishes and maintains a system for monitoring the matters set out in Schedule 6 at appropriate intervals and for improving the quality of care provided (Regulation 34 (1)) 28/02/2011

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Std. Action Due date

34 ensure that the person appointed to manage the children's home has the qualifications, skills and experience necessary to carry on the home with sufficient care, competence and skill. (Regulation 8 and 9) 28/02/2011

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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

 report any frequent refusal to take medication to the prescribing practitioner (NMS 13.2)  review regularly the implementation and effectiveness of action identified as a result of risk assessments carried out, including assessments of a young person's suitability to self-medicate (NMS 26.3)  ensure that staff respect young people's privacy by following the home's guidance on entering a young person's room, carrying out room searches in accordance with the guidance provided and documenting the details of any search in the appropriate log (NMS 9.2, 9.7)  maintain records in accordance with Schedule 4 (6) to demonstrate that there is regular testing of the home's emergency lighting, fire alarms and fire fighting equipment (NMS 26.8)  ensure that young people who are identified as having particular needs receive appropriate help, guidance and support. (NMS 7.1)

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