Children's Home run by Stellakis Miltiadous in Haringey

Unique reference number SC039213 Inspection date 11/08/2011 Inspector Karen Malcolm Type of inspection Full Provision subtype Children's home

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Date of last inspection 19/01/2011 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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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 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

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The inspection judgements and what they mean

Outstanding : a service that significantly exceeds minimum requirements Good : a service that exceeds minimum requirements Satisfactory : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Brief description of the service

The registered children's home provides services to six young people of either sex aged between 12 years and 17 years old who have emotional or behavioural difficulties.

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Overall effectiveness

The overall effectiveness is judged to be satisfactory .

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Overall effectiveness

The home provides a satisfactory quality of care which promotes improved outcomes for young people. Most young people have positive views about the quality of their care the home provides and the relationships with staff are positive. Children are safe and feel safe. Any breaches of regulation have minimal impact on children and young people. Young people do benefit from a stable staff team. Young people do get the opportunities to participate in various activities mainly within the community such as day trips out especially over the summer break. Staff have worked positively with young people giving them informed choices about their future goals.

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Overall effectiveness

However, individual placement and care plans are not used effectively to plan, record or monitor young people’s overall care needs, especially relating to their health. As a result the support in place is inconsistent and insufficiently managed. Young people’s wishes and needs are not always sought or addressed; therefore some young people feel it is pointless complaining as nothing gets done or happens.

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Overall effectiveness

Staff do receive training to carry out their roles and responsibilities. However, when training is to be updated this has not been carried out consistently or effectively. Independent monitoring visits are carried out monthly, but some reports have not been consistently submitted to Ofsted within the specified timescale. Also the views of staff are not always sought or evidenced in the report. Additional to this there is no system in place to monitor the overall quality of care being provided.

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Overall effectiveness

The procedures for when a young person is absent without permission or missing are not properly safeguarded or managed consistently. There are a number of maintenance issues that need addressing.

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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 person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) have a procedure to be followed when any child accommodated in a children's home is absent without permission which has regard to any relevant local authority or police protocols on missing children (Regulation 16(4)(b)) 18/10/2011

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Reg. Requirement Due date

(2001) ensure that each child is provided with guidance, support and advice on health and personal care issues appropriate to his needs and wishes (Regulation 20(2)(d)) 18/10/2011

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Reg. Requirement Due date

(2001) make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children’s home (Regulation 21(1)) 19/09/2011

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Reg. Requirement Due date

(2001) ensure that the home is kept clean and reasonably decorated and maintained (Regulation 31(2)(e)) 19/12/2011

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Reg. Requirement Due date

(2001) establish and maintain a system for monitoring the matters set out in Schedule 6 at appropriate intervals (Regulation 34(1)(a)) 19/12/2011

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Reg. Requirement Due date

(2001) give notice in writing to the HMCI, in the case of the absence of the Registered Manager, the arrangements that have been or are proposed to be made for appointing another person to manage the children’s home during their absence. This is to include the proposed date by which the appointment is to be made (Regulation 37(2)(e)) 21/10/2011

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Recommendations

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

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Recommendations

 ensure children's views, wishes, and feeling are acted upon, in the day-to-day running of the home and important decisions or changes in the child life (NMS 1.1)  have in place a written development plan, reviewed annually, for the future of the home, confirming the continuation of the home’s current operation and resource (NMS 15.2)  ensure that visits of the home carried out under Regulation 33 include the relevant guidance such as records and interviews of any persons working at the home and reports are submitted to Ofsted in the allocated time (NMS 21.7)  demonstrate clearly and include in written and electronic records, that good recruitment practice is followed and all applicable current statutory requirements and guidance, in staff recruitment and carers selection. This includes Criminal Records Bureau (CRB) checks.(NMS 16.2)  ensure that all staff are equipped with the skills required to meet the needs of

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Recommendations

the children and purpose of the setting, and training keeps them up-to-date with professional, legal and practice developments and reflects the policies, legal obligations and business needs of the home (NMS 18.1)

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Outcomes for children and young people

Outcomes for children and young people are satisfactory .

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Outcomes for children and young people

The outcomes for young people living in this home are suitable. Young people feel that their everyday needs are met. Young people do feel that any improvement to the home should be carried out within a timely manner and not left for a long time before they are repaired or addressed. They also feel the home could be more comfortable and homely and that their views should be listened to. All young people spoken to said that they do have a positive relationship with staff and this was observed. Young people know whom they call upon if they need to talk to someone. They also feel that their cultural needs are met; they are matched with staff who are either from the same ethnic cultural background or gender group which they appreciate.

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Outcomes for children and young people

When a young person has a healthcare needs such as an issue with self harming or a weight concern, the information recorded on their care or placement plan, does not clearly evidence what support is in place, and how this is to be monitored. Where there is an element of risk, there is no clear guidance on how this is managed, reviewed or monitored to ensure the young person remains safe at all times. Therefore, young people overall healthcare needs is not consistently managed. All young people are registered with a local doctor’s surgery and all healthcare treatments and appointments have been carried out, some young people have additional support with other health professional. The home has links with health agencies, including specialist services such as Child and Adolescent Mental Health Services (CAMHS) and the psychiatrist. However, it is also unclear how this is managed.

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Outcomes for children and young people

Young people are supported and encouraged to maintain and develop family contacts and friendships. The home feeds back to the responsible authority any significant reactions a young person may have with their contact arrangements or visits. Young people are also are aware that the neighbours have complained about the noise and the behaviour of the young people living in the home mainly when their friends are around. Young people now ensure that all their visitors respect their home and respect the neighbourhood they live in.

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Outcomes for children and young people

Young people are at the initial stages of prepare for and obtaining support into adulthood. Young people spoken to feel ready to move on, but are also aware that they need support and help to achieve this such as obtaining employment or getting information for further education opportunities.

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Quality of care

The quality of the care is satisfactory .

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Quality of care

Young people’s privacy is maintained and confidential records are kept secure. The relationships between staff and young people are based on mutual respect and understanding and there are clear professional and personal boundaries. Young people have a good relationship with staff, especially with their individual key workers whom they see as helpful and supportive. They also know who they can talk to about anything and have done so on a number of occasions. Staff are aware of meeting the needs of the young people and recognise their particular vulnerabilities.

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Quality of care

Young people spoken to all said that once a week they have a young people’s meetings. All had a different view of how well they thought the meetings were. Some felt issues are raised, but are never addressed such as the dryer being out of action for several months although they have reported it several times. Others prefer having one-to-one key-worker meetings; they felt that a one-to-one forum meets their needs appropriately rather than a group meeting. The agenda is managed by staff and young people are able to add any item to the agenda if they so wish. However, it is unclear how young people are able to raise concerns openly and safely in this forum or any other. Young people do not always feel they are listened to; therefore feel raising issues can be pointless. In addition young people report they are not helped to understand when their wishes or concerns cannot be acted upon.

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Quality of care

There is some lack of clarity amongst staff as to what procedures are to be followed when a young person is on prescribed medication and is away from home, or if medication is registered as a controlled drug by the royal pharmaceutical society. There is a medication policy and procedures; however, the policy does not refer to how different areas of administration such as controlled drugs, when away from home and ‘as and when required’ medications are to be administered safely. Therefore, the health needs of young people have not been managed consistently or safely at all times. The majority of staff team are trained in safe administration of medicines, but this has not been updated for sometime.

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Quality of care

Young people are encouraged to take responsibility for their behaviour, in a way that is appropriate to their age and abilities. Staff understand and manage their own feelings and responses to the emotions and behaviours presented by young people and understand how past experiences and present emotions are communicated through behaviour.

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Quality of care

Young people spoken to are all at different stages in their educational life. Some are at school, some want to go on to further education and some need support and guidance to obtain employment for their various chosen career. They are all clear about their goals and what they want to achieve. Staff engage and work with schools, colleges and other organisations to support young people with their education including advocating to help them overcome any problems the young person may be experiencing in their educational setting. As it is the summer term, young people are preoccupied with planned activities and spending time away from education, but they also know that time is ticking by fast and they need to plan for their future. Staff value education and understand their role to enable young people to achieve this. The home develops suitable relationships with schools to support young people.

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Quality of care

Young people pursue individual interests and hobbies; this includes taking part in a range of activities such as swimming and day trips to the seaside. The main focus on activities is based locally such as shopping trips and within the month of August there is a full programme of activities for all.

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Quality of care

Placement and care plans are in place, but some were found to be confusing these did not contain all the information for the young person such as new areas of risk with regards to their health and absent without permission. Each child and young person has an allocated key worker who ensures that that monthly summaries are completed and care plans did highlight individuals' diverse and cultural needs.

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Quality of care

The home is situated in a residential area. All the communal areas are on the ground floor including the staff office and sleeping-in room. Throughout the home there are a number of maintenance issues that are identified and need immediate attention, such as the dryer, which has been out of action for several months. Some young people informed the inspector that they did not know there was a dryer in the home, as they have always dried their clothes in their bedrooms. Young people say that they had asked for rugs as the flooring in their rooms is cold especially in the winter months, but nothing has been done. The deputy manager is aware of some of the maintenance issues but is waiting on the Registered Person to address them. There are no clear plans in place as to when the works are to be undertaken or completed. The home is spacious. Young people are happy with some parts of the home. The communal areas consist of a sitting/dining room, a kitchen and a computer room and

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Safeguarding children and young people

The service is satisfactory at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Young people rarely go missing from the home. However, where a young person has gone missing or is absent without permission, it is unclear how these incidences are risk assessed to minimise the safety and protection of the young person. There are a number of high incidents where young people are absent without permission and where their whereabouts is known or thought to be known by staff. In these cases young people are not fully protected due to an inconsistent approach undertaken by staff,. There is some lack of clarity amongst staff as to when a young person is absent or missing, this was reflected in the records seen. The missing person policy although has been updated was not available at the time of visit.

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Safeguarding children and young people

Young people report that they generally feel safe in the home. Young people feel that they can identify an adult they would talk to if they felt unsafe. Staff recognise particular vulnerabilities relating to the diverse needs of young people, and have taken appropriate action to address them. Young people spoken to say that they know the consequences of coming home after their curfew times and those who had moved in recently said that they feel settled and comfortable.

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Safeguarding children and young people

The staff have created an atmosphere where bullying is known to be unacceptable. There is a policy on countering bullying, which is known to young people and staff and is effective in practice. There are suitable arrangements for safeguarding young people. Policies relating to the protection of young people comply with regulations and refer to the Local Safeguarding Children Board. The disciplinary guidance clearly highlights the importance of reporting safeguarding matters and staff training on safeguarding and child protection needs updating for some staff.

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Safeguarding children and young people

Young people are assisted to develop socially acceptable behaviour through encouragement of acceptable behaviour and constructive staff response to inappropriate behaviour. Sanctions given are deemed fair by young people and records clearly show that this. No recorded restraint has been used since the last visit. There is clear monitoring of the use of restraint, and appropriate action is taken as a result of such monitoring to reduce it’s wherever it is used.

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Safeguarding children and young people

The environment is physically safe and appropriately secure, taking account of the needs and characteristics of the young people cared for. There is clear evidence that young people are involved in monthly fire drills that are carried out; therefore they are able to respond appropriately in an emergency.

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Safeguarding children and young people

There is careful selection and vetting of all staff working with young people in the home and there is a clear monitoring of visitors to prevent young people being exposed to individuals who may cause them harm. However, in the light of any criminal convictions or other concerns about the suitability of a person employed there is no clear evidence how this is risk assessed to ensure the person is checked and remains suitable for the post.

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Leadership and management

The leadership and management of the children's home are satisfactory .

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Leadership and management

The home has not been effectively and efficiently managed for sometime. The Registered Manager manages two children's homes owned by the organisation and there is a clear rota to manage her time between the two establishments. However, for sometime the Registered Manager has not been able to fulfil these duties appropriately. There is an arrangement for staff to deputise in the Registered Manager’s absence and staff are clear about their roles and responsibilities. However, the level of delegation and responsibilities has not been clearly handed over. Without this direction there is an impact on the smooth running of the service and the quality of records, which are not consistently and appropriately managed, monitored or reviewed. Independent monitoring visits have been carried out, but the quality assurance of the service has not been undertaken. Therefore, records such as missing persons, the maintenance of the building, staff training, recruitment records,

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Leadership and management

young people’s views, and young people’s care and placement plans have not been effectively monitored as required by the regulations. The monitoring report gives a brief overview of the service. However, some reports have not submitted to Ofsted within the specified timescales and staff views are not always sought as part of the process

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Leadership and management

The Statement of Purpose does provide prospective young people and their representative an overview of the services provided. Young people say that when they moved into the home, they were given a copy of the young person's guide. They all said that the document given was informative especially the ground rules which newly accommodated young people found very useful.

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Leadership and management

There is a stable and sufficient staff team that provides continuity and support to young people living within the home. Young people are looked after by a caring staff team. There are appropriate arrangements in place for staff to receive support, training, supervision and appraisal of their performance. However, these have not been carried out consistently and some training refreshers are out of date. The deputy manager does not have a clear overview of what training staff have undertaken and what are their individual training needs. Staff feel supported by management; although at present they are unsure of the current management arrangements. Everyone is flexible and open and feel that the team is good. Team meetings provide staff with an opportunity to discuss practice and up-to-date information.

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Leadership and management

The deputy manager is aware of the strengths and weaknesses of the home. However, the deputy manager is unable to make financial decisions and therefore, maintenance repairs have not been addressed within a timely manner.

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Leadership and management

Staff maintain young people's case files securely and keep information confidentially. Files evidence adequate background of information as required. However, it is unclear if young people are able to facilitate their information easily.

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Leadership and management

The home has taken reasonable steps to ensure good relationships with neighbours and the wider community. All complaints received from the neighbours are addressed by the manager. However, it is unclear whether a complaint received by Ofsted in June 2011 had been addressed appropriately as there was evidence of this on file.

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Leadership and management

All significant events relating to the protection of young people accommodated in the home are notified by the registered person. However, risk assessments are not automatically updated to revise the new risk that is now in place.

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Leadership and management

Equality and diversity practice is satisfactory .

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