Children's Home run by Birtenshaw in Bolton

Unique reference number SC397344 Inspection date 08/03/2010 Inspector Russell Shackford Type of inspection Key

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Date of last inspection 28/08/2009 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 provides care and accommodation for children and young people who have learning and physical disabilities. It is situated in a residential area and has access to a wide range of local amenities. The property is domestic in size and adapted to meet the needs of children and young people with disabilities.

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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 was a key inspection to check on all key standards and related regulations under the Every Child Matters outcome groups for young people. This is an inadequate service.

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Summary

Young people are given choices about their food and the food served is both healthy and nutritious. Staff encourage and support good school attendance but education plans in the home are significantly out of date. Healthcare planning and evidencing is poor. There is poor advocacy on complaints. The staff demonstrate satisfactory knowledge of child protection procedures but make no reference to the safeguarding needs of the adults living in the home. Leisure and social needs are not adequately met.

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Summary

Placement planning is poor and significantly out of date. It is not adequately recorded or reviewed. Young people do not receive care and support which helps to fully prepare them for adulthood. The home is kept very clean and there are homely touches throughout. Staffing is often insufficient to meet the full range of young people's needs and not all staff are adequately trained and competent.

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Summary

The Registered Manager of the home does not exercise effective leadership of the home’s staff and operation, to ensure that the home is organised, managed and staffed in a manner that delivers the best possible outcomes for children. There is inadequate monitoring of the welfare of the children in the home. The promotion of equality and diversity is inadequate.

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Improvements since the last inspection

This is the first inspection since registration was achieved and therefore there are no previous actions or recommendations.

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Helping children to be healthy

Young people are given choices about their food and the food served is both healthy and nutritious. Staff encourage young people to eat healthy foods and snacks. Staff involved in preparing food for others have received appropriate training in safe food handling and hygiene.

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Helping children to be healthy

However, opportunities for young people to be involved in shopping for food are limited because staffing levels are not always adequate to do so. The young people are involved in the preparation of meals and there are opportunities to make snacks and bake. Participation is enhanced by the recent fitting of rise and fall kitchen work surfaces and a sink.

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Helping children to be healthy

The staff are aware of individual young people's likes, dislikes, eating techniques and allergies. This is only partially supported by fragmented and out-of-date health planning and information records. There are ‘one off’ notes in the case files that highlight particular issues for staff to be aware of, such as allergies, but these poor records do not support the staff in meeting the young people's up-to-date needs using planned, consistent methodology.

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Helping children to be healthy

All young people are registered at local health services such as doctors, dentist and opticians. They have access to, and are visited by other health services such as occupational therapist, speech and language therapist, wheelchair clinic and psychological services. The staff liaise with the placing authority to commission other services as required. This is only partially supported by fragmented and out of date planning and information records. The healthcare plans are said to be incorporated into the placement plans but the placement plans in use are significantly out of date and do not give up-to-date information about the young people's current healthcare needs. Therefore, young people's health needs are only satisfactorily promoted.

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Helping children to be healthy

Young people are involved in healthy activities at school such as trampoline, cycling and the hydrotherapy pool. However, healthy activities at the home and in the community are limited due to inadequate staffing levels and poor planning. This does not adequately promote young people's good health.

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Helping children to be healthy

Staff are trained in medication matters to enable them to safely store, administer and record the medication that they are responsible for. Medication is securely stored and records are up to date and accurate. However, there is no system in place for checking the records against the stock levels. All staff have received training to enable them to provide first aid if necessary. Staff have also received specialist training to meet young people's specific health needs. Therefore, young people's health needs are met and their welfare is satisfactorily safeguarded by the home’s policies and procedures for administering medicines and providing treatment.

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Protecting children from harm or neglect and helping them stay safe

Staff demonstrate good understanding of facilitating privacy for the young people. This is done sensitively and safely. Details about young people's care is recorded and stored appropriately, to maintain appropriate levels of confidentiality. Young people can make telephone calls in relative privacy. Therefore, privacy is well respected in all aspects.

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Protecting children from harm or neglect and helping them stay safe

All staff have received training on complaints, to ensure that they know what to do if a person complains about the service. This is supported by written guidance for staff. However, the staff do not demonstrate sufficient understanding of their role as advocate for the young people in enabling them to complain about the service provided. There have not been any recorded complaints about the service since registration was achieved.

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Protecting children from harm or neglect and helping them stay safe

The manager and staff have received child protection training. The provider has a satisfactory safeguarding children procedure for staff to follow, in the event of any allegation or suspicion of abuse. Staff demonstrate satisfactory knowledge and understanding of the safeguarding procedures, to promote and protect the young people's safety. However, the training and guidance for staff does not adequately address the safeguarding needs of the adults living at the home.

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Protecting children from harm or neglect and helping them stay safe

There have been no significant events at the home requiring notification to the relevant authorities including Ofsted. There is written guidance for staff to follow if a significant event occurs.

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Protecting children from harm or neglect and helping them stay safe

The behaviour management policy is constructive and reflects the age, understanding and individual needs of the young people concerned. It recognises that unacceptable or challenging behaviour may be the result of certain disabilities or communication difficulties, therefore, does not promote the use of sanctions or consequences in response to the young people's behaviours.

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Protecting children from harm or neglect and helping them stay safe

However, there was one instance described by a staff member of a behaviour management technique they had used which was contrary to the provider’s policy. This measure was also not recorded as required. The head of care confirmed that these measures were contrary to the providers policy and should not be used.

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Protecting children from harm or neglect and helping them stay safe

Physical restraint is rarely used to manage behaviour where no other alternative exists. The behaviour management training focuses upon defusing techniques designed to minimise the need for any other intervention such as physical restraint. However, not all staff have received up-to-date training in the provider's policy and authorised techniques. There are no incidences of physical intervention recorded.

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Protecting children from harm or neglect and helping them stay safe

Risk assessments have been carried out to minimise the risks to the young people during their known and likely activities. However, the content of the records is poor because it is not clear what action is required of the staff to minimise the identified risks and they are linked to significantly out-of-date placement plans. This does not adequately ensure that any activities in which young people participate are so far as reasonably practicable free from avoidable risks.

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Protecting children from harm or neglect and helping them stay safe

All staff and young people have been involved in regular fire drills. However, not all staff working at the home have received up-to-date fire safety training, to enable them to minimise the risks to young people in the event of a fire at the home. Regular fire safety and maintenance checks are carried out. However, the fire safety check records are disjointed because some aspects of the checks are recorded in a bound book and others are recorded on unnamed loose leaf sheets of paper. This approach does not sufficiently ensure that required records are accurately maintained.

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Protecting children from harm or neglect and helping them stay safe

All staff have been appropriately recruited and they have undergone suitable Criminal Records Bureau checks, to ensure that they are suitable to work with young people.

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Helping children achieve well and enjoy what they do

There are many good examples of individualised support being provided in areas, such as eating, communication, sleeping equipment, occupational therapy, speech and language. However, the young people’s development is compromised by very poor planning of care, support and activities within the home. Poor planning and often inadequate staffing do not support the young people in going out of the home to experience other situations or activities, which are individually appropriate to their personal, health, leisure, social and relationship needs.

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Helping children achieve well and enjoy what they do

Staff encourage and support good school attendance. Education plans in the home are significantly out of date and therefore progress is not satisfactorily evidenced. Statements of special educational needs are significantly out of date. This does not provide up-to-date information for the staff about any special educational needs and how they will be met. A computer is available for the young people to use for educational purposes but it is in need of repair.

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Helping children achieve well and enjoy what they do

There is very poor planning and delivery of leisure activities suited to the individual needs of the young people. This is particularly noted in poor quality activity plans which are predominantly based in the home around television and music. Staff say that staffing levels are rarely adequate to support activities outside of the home. This does not combat the young people's isolation by enabling them to go out of the home to experience other situations or activities, which are individually appropriate to their personal, social, leisure and relationship needs.

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Helping children make a positive contribution

The home's referral system enables the manager to fully assess the needs of the young people concerned and to take into account the likely effects of their admission, upon the existing group of residents. Admissions to the home are planned and the young person and their family, where appropriate, are involved in that planning. Young people may visit the home before they move in. Therefore, young people are able to move into the home in a planned and sensitive manner.

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Helping children make a positive contribution

There is very poor planning, evidencing, monitoring and reviewing of care and support for the young people. The placement plans checked were many years out of date. The head of care said that the plans were being reviewed and a new format was being introduced to improve them. Monthly summaries of the young people's progress are written by key workers. However, those checked were many months out of date. Statutory reviews are up to date but the staff spoken to said that they were not always aware of the outcomes. The outcomes of reviews have not been incorporated into up-to-date placement plans. Therefore, young people do not have their needs assessed effectively and comprehensively, and they do not have up-to- date written placement plans which outline how these needs will be met.

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Helping children make a positive contribution

Young people’s contact is well promoted and facilitated. Staff confirm that young people can keep in touch with people that are important to them and that they can have family and friends come to visit them.

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Helping children make a positive contribution

Staff describe ways in which young people are encouraged to make decisions about their lives and influence the way that the home is run. No young person is assumed to be unable to communicate their views. Young people's participation is very well supported by staff who explore their individual choices, likes and dislikes. Staff seek the views and choices of the young people using objects, pictures and young people's preferred communication techniques, such as yes/no switch, and a computer aided communication aid with words and pictures. The staff demonstrate a good appreciation of non-verbal communication used such as eye and body movements to indicate preferences. They take into account the views of other people who know the young people well such as parents and teaching staff. Therefore, young people’s views are sought and in the main, acted upon. This is a notable area of strength.

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Achieving economic wellbeing

The daily life of the home does not provide opportunities for all young people in the home, appropriate to the age and needs of each young person, for the development of knowledge and skills needed by them for future, more independent living. Transition plans are not recorded for the young people approaching adulthood. In the absence of formal transition plans, the staff rely upon placement plans which are significantly out of date. Therefore, the young people’s development and preparation is compromised by poor planning and opportunities to go out of the home to experience other situations or activities which are individually appropriate to their adult personal, health, social and relationship needs.

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Achieving economic wellbeing

The interior and exterior of the home are maintained in a good state of structural and decorative repair. There is a good maintenance and repair programme for the building, furniture and equipment and any damage is repaired promptly. The garden is well maintained and safe. The home is kept clean and there are homely touches throughout.

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Organisation

A Statement of Purpose is available, to inform professionals and members of the public about how care is provided at the home. ‘However, the content does not currently reflect the agreed conditions of registration. There is a satisfactory children’s guide to the statement. It is available in a written and picture format. Before admission, the staff provide as much information as they can about the home to young people, so that they know what to expect if they come to live there.

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Organisation

There is a consistent staff team, which has a range of skills and experience among its members. The staffing is not always adequate to meet the home’s Statement of Purpose. However, the home’s staffing is not always sufficient in practice to meet the needs of the young people accommodated. The manager does not always increase the number of staff looking after young people above the minimum required by the Statement of Purpose where young people's needs, or other circumstances require this. This is particularly noteworthy around the lack of opportunity for young people to go out of the home to experience other situations or activities which are individually appropriate to their adult personal, health, social and relationship needs.

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Organisation

New members of staff receive induction training before commencing work with the young people. Staff refer to written guidance during discussion and give examples of how it is implemented in practice. Staff supervision is described as, 'good'. There is an ongoing programme of training and refresher training provided in a range of subjects, to enhance the staff's competency to meet the needs of the young people. However, not all staff have received up-to-date training in subjects that equip them with the skills required to meet the needs of the young people and the purpose of the home such as care planning, fire safety, adult protection, equality and diversity and physical intervention. During discussion, staff demonstrated poor knowledge of some social care subjects such as equality and diversity and the legal status of the young people. The target of 80% of staff having achieved National Vocational

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Organisation

Qualification at level 3 in caring for children and young people is not met. Therefore, the young people are not receiving care from staff who are themselves sufficiently competent and qualified to meet their needs. The provider undertakes monthly, unannounced monitoring visits to the home. This is to ensure that the care of children can be adapted, in the light of information about how the home is operating. However, neither the monthly unannounced monitoring visits undertaken on behalf of the organisation or the Registered Manager’s monthly monitoring adequately identified shortfalls in, for example, the lack of up to date care planning for young people. This means that arrangements for the monitoring of the quality of care are not sufficiently robust to fully promote the welfare of the young people in the home

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Organisation

The Registered Manager does not exercise effective leadership of the home’s staff and operation to ensure that it is organised, managed and staffed in a manner that delivers the best possible care and safeguarding outcomes for young people.

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Organisation

The promotion of equality and diversity is inadequate. There are poor approaches to promoting equality and diversity detailed in all outcome areas. Examples of inadequate practice are in areas such as safeguarding individuals, individual risk, advocacy on complaint, support for individual needs, personal and social health, staff competence to meet individual needs and the monitoring of individual needs being met.

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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

12 prepare a written plan for each child setting out the arrangements made for his health care (Regulation 12 (1) (b)) 19/04/2010

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Std. Action Due date

16 ensure that children accommodated in the home are enabled to make a complaint or make representation (Regulation 24 (6) (a)) 19/04/2010

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Std. Action Due date

17 implement the written policy which is intended to safeguard children accommodated in the children’s home from abuse, in particular, recording the action taken in response to suspicion of abuse and the outcome (Regulation 16 (1)) 10/03/2010

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Std. Action Due date

22 ensure that any measure of discipline used is not unreasonable (Regulation 17 (1)) 10/03/2010

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Std. Action Due date

26 ensure that unnecessary risks to the health or safety of children accommodated in the home are identified and so far as possible eliminated (Regulation 23 (c)) 19/04/2010

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Std. Action Due date

26 make arrangements for persons working at the home to receive 10/03/2010 suitable training in fire prevention (Regulation 32 (1) (d)) 7 ensure that each child is provided with such individual support as he may require as a result of any particular needs or disability he may have (Regulation 11 (1) (b)) 19/04/2010

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Std. Action Due date

14 ensure that for each child there is, where appropriate, an up-to- date copy of any statement of special educational needs with details of any such needs (Regulation 28 (1) (a) and Schedule 3) 19/04/2010

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Std. Action Due date

15 ensure that children accommodated in the home are encouraged to develop and pursue appropriate leisure interests and provided with appropriate leisure facilities and activities (Regulation 18 (2)) 19/04/2010

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Std. Action Due date

2 prepare in consultation with the child’s placing authority a written placement plan for the child setting out in particular how, on a day-to-day basis, he will be cared for, and his welfare safeguarded and promoted by the home, and the arrangements made for his health, care, leisure and education; and any arrangements made for contact with his parents, relatives and friends (Regulation 12 (1)) 19/04/2010

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Std. Action Due date

6 ensure that there is a written plan for young people which specifies the support and assistance they will need to receive to enable a successful transition into adulthood, and which is implemented in practice. This plan must be consistent with the any transition plan for children with disabilities and special educational needs (Regulation 12 (4) (a)) 19/04/2010

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Std. Action Due date

1 compile in relation to the children’s home an accurate, written statement of purpose which shall consist of a statement as to the matters listed in Schedule 1 (Regulation 4 (1)) 19/04/2010

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Std. Action Due date

31 ensure that all persons employed at the home receive appropriate training and supervision (Regulation 27 (4) (a)) 28/06/2010

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Std. Action Due date

30 ensure that there is at all times, having regard to the Statement of Purpose, and the number and needs(including any needs arising from any disability) of the children accommodated there a sufficient number of suitably qualified, competent and experienced persons working at the children’s home (Regulation 25 (1)) 10/03/2010

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Std. Action Due date

33 establish and maintain a system for monitoring the matters set out in Schedule 6 at appropriate intervals; and improving the quality of care provided in the children’s home (Regulation 34 (1)) 19/04/2010

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Std. Action Due date

32 establish and maintain a system for monitoring and improving the quality of care provided in the children’s home. (Regulation 33) 19/04/2010

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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 stocks of medication and the records of administration are regularly monitored by an appropriate designated senior member of staff (NMS 13)  improve the fire safety check records by including the name of the service and combining the outcomes of the different checks in one central recording system. (NMS 26)

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