Children's Home run by Able Health Care Ltd in Suffolk

Unique reference number SC408714 Inspection date 16/02/2011 Inspector Jeffrey Banham Type of inspection Key

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Date of last inspection 30/04/2010 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children’s Services from: The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000.

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About this inspection

This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcomes for children set out in the Children Act 2004 and the relevant National Minimum Standards for the service.

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The inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough

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Brief description of the service

This children's home is owned and managed by a private organisation. It was opened in April 2010 and is registered to take a maximum of six young people aged between 10 to 17 years. It has its own school on the premises. The home is located in a residential street close to the town centre and enables young people to have easy access to a range of amenities. The home has been renovated to provide high standards of accommodation with all young people having their own bedroom. There is a large living room and a well-equipped kitchen and dining room. Car parking is available on the street and on the front drive. There is a large enclosed garden at the back.

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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

At this unannounced visit all key standards were inspected. This was the first inspection since registration of the children's home. This is a satisfactory service with some good features.

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Summary

The physical premises of the home and its location are good. It is well furnished and decorated and has been renovated to a high standard. Accommodation is clean and homely.

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Summary

The staff team is relatively new and has had a number of changes since the first child was admitted in August last year. This has meant that the team is still new and some staff are relatively inexperienced. The induction to the home is thorough but a proper and coherent training plan to develop staff past induction has yet to be fully implemented.

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Summary

The ability of the manager to develop polices, practices and procedures has been affected by the need to stand in to respond to staff shortages. This has impacted on the ability of the team to provide consistent and effective care at all times and some aspects of practice are not yet fully embedded. Examples of these include the development of explicit strategies to enable the whole staff team to manage non- attendance at school consistently and for the team to provide effective supervision of young people in the home at all times.

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Summary

The home has not yet developed a contact with a provider of advocacy for young people should this be required.

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Summary

Young people are well cared for and are seen, according to one young person's social worker, to be "thriving" and secure in the placement. Although some information on young people is not provided before admission to the home the staff are acutely aware of the backgrounds of the young people and care plans are drawn up to take previous experiences into account. Staff are caring and sympathetic and in general have established good relationships with the young people. They work hard to encourage and develop interests and hobbies for young people and to develop their potential. Young people feel safe in the home. However fire evacuation procedures have yet to be properly undertaken with all staff and the identity of visitors is not always established.

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Improvements since the last inspection

Not applicable. This is the first inspection since registration.

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Helping children to be healthy

Despite the fact that young people currently living in the home have had difficulties in the past with engaging with health professionals staff work to ensure their health care is promoted. One social worker from a placing authority remarked, for example, on how much the young person had grown and "thrived" since being in the home. Young people are registered with all the appropriate health care providers. Care staff have worked with the local GP for example to have young people registered at the surgery.

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Helping children to be healthy

Information on health care needs is obtained as part of the planned admission process. Care staff work with young people through key worker sessions to promote healthy lifestyles and to ensure that young people have all the necessary information to be able to take responsibility for their own health care where this is appropriate. Written consents to treatment are obtained from the placing authority. Health care needs and necessary actions are identified as part of the written health care plans and progress is reviewed through the statutory reviewing process.

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Helping children to be healthy

Mealtimes are seen as social occasions to be enjoyed. Menus are discussed with the young people and a balance is struck between allowing them their choice foods at all times and the encouragement of healthy eating. Individual preferences and habits are recognised and taken into account at mealtimes and in the buying and preparation of food. Young people who enjoy cooking are supported and encouraged to be involved in all aspects of food preparation and healthy food such as fruit and vegetables is available in the home. A vegetable plot is being prepared in the back garden. Staff are encouraging young people to be involved in the growing of vegetables to be eaten in the home.

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Helping children to be healthy

Although the home has the facilities for the safe storage of medication, a locked cupboard and lockable cabinets for example, few staff have had specialist training in the storage and administration of medication. New staff have had an introduction to the administration of medication from the Registered Manager. Staff however feel that more specialist training is required, particularly should a young person taking controlled medication be admitted to the home. No young people who live in the home are currently on controlled or prescribed medication but this lack of training leaves young people who may need medication at risk of being supported by staff not adequately trained.

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Protecting children from harm or neglect and helping them stay safe

The home has a range of policies and practices to ensure young people are cared for safely in the home. Young people are able to feel safe and secure in their own bedrooms and bathrooms which have doors that they can lock but which can, if necessary, be overridden from outside. Staff are clear about action to be taken if bullying occurs or is suspected, or if young people go missing from the home. Young people have access to a complaints process that has not yet had to been used.

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Protecting children from harm or neglect and helping them stay safe

The management of behaviour is based on the promotion of positive behaviour and the home has a "positive consequences" record which enables young people to gain points for positive behaviour leading towards the provision of some activity or purchase agreed with the young person. All young people have a behaviour management plan based on written risk assessments.

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Protecting children from harm or neglect and helping them stay safe

Staff are trained in appropriate and safe behaviour management techniques. Detailed records are kept of all sanctions and physical intervention techniques. These are monitored by the manager and by the home's independent visitor. Young people are given ample opportunity to reflect on their behaviour and the actions of staff trying to keep them or others safe. Staff responses to young people's behaviour are discussed at individual staff supervision sessions and through team meetings. This promotes regular reviews of staff and team approaches and enables effective responses to challenging behaviour be developed by the staff team.

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Protecting children from harm or neglect and helping them stay safe

The home has a written child protection policy and access to the procedures of the Local Safeguarding Children Board. Staff are given an introduction to child protection training in their induction to the home. The home does not however have a structured training programme to provide further child protection training. Given that the home has a number of new and inexperienced staff this represents a deficiency in the development of staff and in their potential to keep young people and themselves safe.

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Protecting children from harm or neglect and helping them stay safe

Staff recruitment and selection procedures are robust and ensure that all staff employed in the home are assessed to be safe to work with children. However staff do not always establish the identity of visitors before they are admitted to the home. This increases the risks to young people and staff.

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Protecting children from harm or neglect and helping them stay safe

The home has a range of procedures to ensure the safety of staff and residents, including risk assessments of premises and activities and regular fire checks to equipment. The home has had one fire drill since it opened in April last year. This was during the day, and some new staff have not taken part in a fire evacuation exercise.

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Helping children achieve well and enjoy what they do

A detailed admission policy and procedure enables young people to come to the home in a planned way. This promotes their safety and security and minimises the impact on existing residents. Information is obtained to enable staff to draw up placement plans based on detailed risk assessments. There are occasionally gaps in appropriate information, such as statements of special educational need and current personal education plans. These are not always obtained before admission but on the whole staff are aware of the needs of young people and the care and support they require. The individual key worker sessions assist staff and young people to develop sensitive and mutually respectful relationships.

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Helping children achieve well and enjoy what they do

The home has not yet established a working relationship with any person or organisation who can provide, should it be required, someone independent of the home who young people may contact directly for help with personal problems or concerns.

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Helping children achieve well and enjoy what they do

The home has its own school on the premises and young people attend. Young people can have experience of difficulties with education and their attendance and participation in school varies according to their attitudes and circumstances. Staff work hard to encourage participation in education through both formal and informal activities. Attendance records show that this approach can be successful at times. Staff have a number of responses to young people not getting up for school, or not attending education. These include keeping their bedroom door open in the morning when they should be up for school, and not allowing them access to TV or DVD downstairs. There is however no overall explicitly understood strategy that is activated by the whole staff group. Staff responses are implicit and depend on the staff group on duty at the time, and there is a lack of application of a strategy throughout the whole staff team, including those coming on duty later in the day.

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Helping children achieve well and enjoy what they do

The energy, commitment and enthusiasm of the staff is therefore not always directed in the most effective ways to promote young people's educational achievement.

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Helping children achieve well and enjoy what they do

Staff work with young people to involve and introduce them to a range of activities and interests to provide enjoyment, develop interests and enhance their self esteem.

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Helping children make a positive contribution

Young people are admitted to the home in accordance with the Statement of Purpose and the home's admission policy. This ensures that the home is able to meet the assessed and agreed needs of young people and that the impact on existing residents is taken into account. Care plans are drawn up on the basis of the information provided from placing authority. Each young person is supported by a "key worker team" and this enables staff and young people to develop sound and supportive relationships. The key worker works with the young person to check progress, ascertain wishes and feelings and ensure that everything is being done to support the young person appropriately. Young people are given every opportunity to be actively involved in the plans that are constructed and the activities that are agreed to provide them with support. They are also encouraged to be involved in their reviews. Young people are supported to have their say through regular

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Helping children make a positive contribution

meetings with staff and through these processes are given every opportunity to make decisions about their lives and the way in which the home is run.

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Helping children make a positive contribution

The care plans are regularly reviewed through the key worker arrangements whereby the worker meets with the young person each week. The statutory reviewing process ensures that he placing authority is able to check a young person's progress. The home ensures that reviews take place in accordance with need and not simply to conform to statutory requirements.

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Helping children make a positive contribution

Young people are supported to have contact with parents and others who are important to them where this is in their interests. Contact is promoted by staff and parents are welcomed to the home. Staff challenge perceptions and attitudes to contact. For example one record of a statutory review said "(the young person's) behaviour and compliance has resulted in him being able to have contact with his mother at her home every other Saturday". The Registered Manager challenged this comment and clarified that contact could not be given or withheld as a sanction or as a reward.

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Achieving economic wellbeing

Young people currently living in the home have not yet reached the age where detailed leaving care arrangements or plans are in place. Their care plans do however set out the longer term objectives to which the home is working to support the young people over time. Although policies for supporting young people leaving care are in place the staff team has not yet had the opportunity to put these procedures into operation.

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Achieving economic wellbeing

Young people are supported and encouraged to manage their own money and to buy their own clothes and toiletries. They are assisted by staff where this is deemed appropriate. The home's location and design serve the needs of the children it accommodates and provides a homely and attractive environment in which they can live and gives them easy access to local amenities. Staff do not always establish the identity of visitors before they are admitted to the home. This increases the risks to young people and staff.

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Organisation

The home opened in April 2010, admitted its first child in August and is operating according to its Statement of Purpose. All admissions have been planned. The management of the home and the development of its practice have been affected by unanticipated turnover of staff. Whilst the home has always been fully staffed to meet the needs of children this has sometimes been achieved through overtime, use of agency staff and the manager working as a residential worker. This has resulted in something of a delay in establishing a stable and secure staff team, and a number of current staff are relatively new and inexperienced.

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Organisation

A thorough induction process which extends for several months and leads towards the attainment of National Vocational Qualifications (NVQ) at level 3. More structured follow-up training, linked to staff personal development plans and appraisals, has not yet been fully developed. Some staff for example have not yet had child protection training other than through induction, or training in the safe handling of medication from a qualified person.

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Organisation

In addition the need for the manager to spend time in direct work as a member of staff has impacted on the ability to spend sufficient time developing policies and practices and establishing what has been a changing staff team. This has resulted in some areas of practice, such as the ability of staff to effectively supervise young people at all times, to be not fully developed.

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Organisation

The staff team is however committed and enthusiastic and staff have developed positive relationships with young people. Staff are keen to develop their practice and have regular team meetings and supervision with the manager to focus on personal and team development. Outcomes for young people are good. For some the period in the home has been amongst the most stable and positive of their lives. The promotion of equality and diversity is good. Staff are aware of young people's previous experiences and backgrounds and take this into account when managing their behaviour.

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Organisation

The practice of the home is regularly monitored by an independent visitor. This leads to a review of care practices undertaken by the manager and forms the basis of the plan which is intended to underpin the continuing development of the home and its practice.

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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

31 ensure that all persons employed receive training, supervision and appraisal and are enabled from time to time to obtain further qualifications appropriate to the work they perform (Reg. 27 (4)) 30/04/2011

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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 first aid, minor illness treatment the administration of medication at the home are given only by competent designated staff (NMS 13)  review the provision of child protection training for all staff to ensure it is included in induction programmes for new staff and is ongoing for the staff group in keeping with the aims and objectives of the home (NMS 17)  ensure that at least four fire drills, including evacuation of staff and children from the building, and fire drills held at night, take place in a 12 month period and are recorded (NMS 26)  ensure that young people have access to at least one person, independent of the home and the child's placing authority, whom they may contact directly about personal problems or concerns at the home (NMS 7)  ensure each child's file contains a copy of their current personal education plan and other essential information (NMS 14)  ensure that the whole staff team provides young people with individualised

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Recommendations

support and that young people receive help guidance and support when needed (NMS 7)  ensure that all staff take effective precautions to ensure the security of the home from access by unauthorised persons (NMS 23)  ensure that the responsibilities of the registered manager promote effective leadership of the home's staff and operation, such that the home is organised, managed and staffed in a manner that delivers the best possible care. (NMS 34)

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