Children's Home run by Institute of Integrated Systemic Therapy in Norfolk

Unique reference number SC065792 Inspection date 09/12/2010 Inspector Dorrit Andrews Type of inspection Key

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Date of last inspection 30/03/2010 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 operated and owned by a registered charity. The home provides medium to long-term therapeutic placements for psychologically traumatised young people. It can accommodate up to five young people, of either gender, aged between 11 and 17 years.

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Brief description of the service

The home is a five bedroom, two storey property with surrounding gardens. It is situated on the outskirts of a small village but within easy reach of local amenities in local market towns and a nearby city. Four young people are currently living at the home, all of whom contributed to the inspection.

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Summary

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

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Summary

This was an unannounced full inspection and all key standards were inspected. All of the outcome areas were covered. Being healthy, staying safe, positive contribution, economic wellbeing and organisation have each been judged as good. Enjoying and achieving has been judged as outstanding.

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Summary

Young people are provided with a good level of care and benefit from staff who have a very good knowledge and understanding of their needs. Staffing levels provide highly individualised support and the team continues to be supported in their work by professional consultants and external professional training.

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Summary

Recent changes to the management structure of the home are now established and there has been a programme of recruitment to secure a full complement of staff. The home is now more settled and there is a shared commitment to its continuous development.

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Summary

A refurbishment programme of internal and external areas of the home is currently taking place. This includes the change of use of some rooms and an additional bathroom.

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Summary

Records and documentation are maintained to a good standard overall. However, not all medication records are appropriately signed and not all entries on case records are signed and dated. In addition, some placement plans do not fully capture the contribution being made by staff in relation to young people's cultural needs. One action and two recommendations have been made in relation to these matters.

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Summary

The recommendation raised at the last inspection has been addressed.

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Improvements since the last inspection

At the last inspection the provider was asked to ensure that records detailed all action taken in relation to incidents of young people absconding. This matter has been attended to.

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Helping children to be healthy

Young people are provided with a balanced diet and are able to help with preparing meals and shop for food with staff. Menus include young people's suggestions and take account of individual dietary needs. Meal times are organised and set up to be social occasions to encourage interaction and develop young people's social skills. Young people report they are able to access the kitchen, staff support them to eat healthily and they always have a choice of food.

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Helping children to be healthy

The physical and emotional health care of young people is promoted. Individual health care needs are identified and health care services and guidance are sought to meet those needs. Good records are maintained of treatment received and refused. Staff are open to discussing a range of health and welfare topics with young people, including maintaining a healthy diet, keeping safe and relationships.

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Helping children to be healthy

Regular exercise and the pursuit of individual interests and activities continues to be encouraged to promote young people's physical fitness and to enhance their emotional well-being. Examples of activities currently engaged in by young people include football, swimming, horse riding and meeting up with friends.

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Helping children to be healthy

Medication and first aid training is provided to staff and refresher courses accessed as necessary. Records of accidents, treatment and medication are well kept overall. However, not all medication records are appropriately signed. This limits the effectiveness of monitoring.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy is respected and staff maintain appropriate levels of confidentiality. For example, staff do not discuss young people in front of others, they knock on bedroom doors and handle information appropriately. Written guidance is in place for staff regarding privacy, confidentiality and safe care practices.

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Protecting children from harm or neglect and helping them stay safe

Young people are aware of who they can turn to when they have a problem or a complaint. They are provided with details of the home's complaint procedure and that of their placing authority. Regular opportunities are made available to young people to voice any issues or concerns they may have. Opportunities include daily contact with staff, group and community meetings. No complaints have been received by the home since the last inspection and no complaints have been received by Ofsted in relation to the home.

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Protecting children from harm or neglect and helping them stay safe

The welfare of young people is promoted and systems are in place to protect them from abuse and bullying. These include a range of policies and procedures, safeguarding training and regular discussion of working practices. These provisions enable staff to respond appropriately to issues and promote the welfare of young people. Bullying is not tolerated and any issues are promptly dealt with. Young people do not identify bullying as a problem at the home and report that when incidences have occurred staff dealt with them 'very well'. Community meetings continue to provide a forum for open discussions of a range of matters including keeping safe and the impact of an individual's actions on others. Staff are vigilant in their supervision of young people and any group activities.

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Protecting children from harm or neglect and helping them stay safe

Guidelines are in place for staff regarding the action to take if a young person goes missing. There has been one recorded incident since the last inspection. Good records are made of the circumstances of incidents and appropriate parties are kept informed. Staff are in regular contact with educational establishments and monitor attendance.

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Protecting children from harm or neglect and helping them stay safe

The management of behaviour is based on establishing positive relationships with young people, communicating clear expectations and developing strategies of support. Emphasis is placed on changing unacceptable behaviour rather than punishing it. Staff continue to receive regular behaviour management training including de-escalation techniques and the use of physical intervention. Behaviour and risk management plans are included in each young person's placement plan and may include specific guidance for staff in relation to the use of restraint. Records of sanctions and the use of physical intervention are maintained and monitored. Young people can express their views and have them recorded. Staff report a lessening of incidents over recent months and records confirm this.

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Protecting children from harm or neglect and helping them stay safe

A range of health and safety policies and procedures are established to support the maintenance of a safe environment. Risk assessments are carried out in relation to the premises and grounds and activities off and on site, and are regularly reviewed. Suitable safety and servicing checks are conducted, fire safety training is provided to staff and fire evacuation drills take place regularly.

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Protecting children from harm or neglect and helping them stay safe

Robust procedures remain in place for the recruitment and checking of staff. Records of visitors are maintained and proof of identification is requested where appropriate. These practices reduce potential risks to the welfare of young people living at the home.

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Helping children achieve well and enjoy what they do

Young people receive an excellent level of individualised support in line with their needs, including support from external professionals. They benefit from staff who have a very good knowledge and understanding of their needs. A team of clinical consultants continue to support the work of the home and meet regularly with staff to discuss individual placement/treatment plans and offer clinical supervision. These practices support the maintenance of individual placements and are a particular strength of the team.

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Helping children achieve well and enjoy what they do

A link worker system is operated and emphasis is placed on individual work with young people. Work is documented and predominantly linked to placement/treatment plans. Young people are seen as individuals and staff are willing and open to discussing a range of sensitive issues. Communication between staff on different shifts is effective and time is allowed for handovers to ensure important information is passed on. Young people report that staff are 'very supportive', spend time with them and provide them with help in understanding their thoughts and feelings. They also say that staff support them in their activities and interests both within the home and local community, including caring for their pets and visiting and meeting up with friends.

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Helping children achieve well and enjoy what they do

The education of young people is actively promoted and supported. Some young people have experienced periods of disruption and are not in full time education so have personalised education plans. Very good links are maintained with educational establishments and staff support school events and acknowledge young people's achievements. Young people are supported with their homework and have access to resources within the home, including books and computers.

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Helping children make a positive contribution

Admissions to the home are planned and tailored to individual circumstances wherever possible. Professionals involved with young people are invited to discuss placement requests with the staff at the home in addition to providing a range of written information including a detailed social history. Where appropriate, parents are invited to visit. Staff meet young people before they are introduced to the home and, wherever possible, introductory visits take place to help prepare the individual and the existing group of residents. Young people can bring personal possessions with them and they are encouraged to personalise their room. Memorable events and achievements of a young person's stay at the home are recorded and young people are supported to move on in a planned way wherever possible.

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Helping children make a positive contribution

Individual needs are assessed effectively and regularly reviewed and updated. Detailed placement/treatment plans set out how these needs will be met and are shared with young people. Some plans do not do not fully capture the contribution being made by staff in relation to young people's cultural needs. Staff encourage and support young people to participate in placement meetings and statutory reviews if only for a short while, Where this proves difficult, link workers will advocate on their behalf and discuss the outcomes of meeting with them.

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Helping children make a positive contribution

Young people are supported to maintain constructive contact with their families, friends and significant others in their lives. Staff work extremely hard in providing practical support including arranging trips to places of interest for sibling groups, travelling long distances and facilitating sleepovers with friends. Arrangements are recorded and any restrictions on contact for the protection of a young person are made clear.

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Helping children make a positive contribution

Regular meetings continue to provide opportunities for young people to contribute ideas and suggestions in relation to the running of the home. Minutes of meetings provide a good record of matters discussed including the refurbishment of the house, staff changes, use of equipment and young people's involvement in choosing and collecting a takeaway at weekends. Particular aspects young people have been involved in recently include the recruitment of staff and the development of the annexe. Parents and other significant people are also consulted and their opinions sought regarding key decisions affecting young people's lives.

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Achieving economic wellbeing

The daily life of the home provides opportunities for young people to develop life skills with the support of staff; for example, helping with cooking and shopping for items for their rooms and the house. Staff also take opportunities to discuss financial matters such as saving and budgeting during their daily interaction with young people. The importance of preparing young people for adult life is acknowledged and further work is being developed in this area. No young person is currently subject to formal leaving care planning. Tasks within the home are shared between male and female members of staff and emphasis continues to be placed on the nurturing role of male and female staff; this promotes positive role modelling.

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Achieving economic wellbeing

A refurbishment programme of internal and external areas of the home is currently under way. This includes the change of use of some rooms and an additional bathroom. Re-decoration has also taken place of a number of areas and further work is planned. The home provides accommodation that is clean and tidy and of domestic style. Each young person has their own bedroom which they are encouraged to personalise with their own theme, posters and personal effects. Communal areas provide different spaces for young people to enjoy.

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Achieving economic wellbeing

The extensive rear garden and play areas are well maintained and provide young people with opportunities for organised and 'free' play. An outside annexe serves as a multi-purpose recreation room and is currently being refurbished with the involvement of young people.

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Organisation

The home's Statement of Purpose is in place, readily available and regularly reviewed. Further updates are scheduled to reflect recent changes to the premises. Separate documentation is provided to young people.

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Organisation

A programme of induction is provided to new staff to familiarise them with the daily working of the home. They are subsequently guided and supported in their work by a system of regular meetings, individual supervision and external consultants. Staff also have access to continuing and post qualifying training in therapeutic childcare through the organisations' university linked worked-based training programme. Personal development needs are discussed during formal supervision and a record of staff training is kept. Comprehensive policies and procedures are also in place and can now be accessed on line. These practices ensure young people receive care from competent staff.

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Organisation

Management of the home is good. Changes to the management structure previously reported have been developed further. Staff report that the roles of the management team are clearly defined and the home is more settled. New staff have been recruited since the previous inspection and have become established team members.

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Organisation

Effective management of staffing contributes to continuity and consistency of care. Cover arrangements are in place for when staff or management are absent or on holiday. Back-up support is always available through the home's rota support and on- call systems. There is also good monitoring of the hours worked to support the welfare of staff and the needs of the home. Young people are made aware of who is on duty and which staff will be sleeping at the home overnight.

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Organisation

Systems are in place to monitor the care of young people and the performance of the home. Copies of Regulation 33 visit reports and Schedule 6 monitoring reports are held on file and made available for inspection. The manager's monthly monitoring reports continue to be used for ongoing evaluation purposes and to focus discussions with staff and young people where appropriate.

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Organisation

The provision of equality and diversity is good. Staff acknowledge the individuality of young people and their differences. The home works hard to provide a supportive and enabling environment to help young people progress and develop as individuals. Young people value the support and individual attention they receive from staff.

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Organisation

Young people's needs, development and progress are recorded. Each young person has a case file which is securely stored. However, not all entries on case files are signed and dated.

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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

35 ensure all written entries on case records are signed and dated by the author. (Regulation 28 (c)) 31/12/2010

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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 medication records are appropriately signed (NMS 13.2)  ensure placement plans consistently capture the contribution made by staff in relation to young people's cultural, religious, language and racial needs. (NMS 2.1)

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