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

Unique reference number SC065792 Inspection date 05/10/2011 Inspector Deirdra Keating Type of inspection Full Provision subtype Children's home

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Date of last inspection 22/03/2011 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

This children's home is owned by a registered charity. It is registered to provide care and accommodation for up to six young people who have emotional and behavioural difficulties. The home is a therapeutic community based on an Integrated Systemic Therapy model.

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Overall effectiveness

The overall effectiveness is judged to be satisfactory .

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Overall effectiveness

Overall, the home provides satisfactory care with some good areas. Staff provide good quality of care which translates well for the majority of young people. Most young people have positive views about their relationships with staff and the care provided. Young people feel secure and their safety is promoted adequately by staff.

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Overall effectiveness

There are areas in safeguarding and the implementation of written policies that require attention. These compromise young people's safety and impact on young people, who do not all feel equally valued. There are also several areas within the management roles that are not defined clearly.

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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

17A (2001) ensure that within 24 hours of the use of any restraint a written record is made in a volume kept for the purpose (Regulation 17B (3)) 02/11/2011

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Reg. Requirement Due date

(2001) ensure that the records specified in Schedule 4 are kept up to date; this relates to the fire drill record. (Regulation 29 (1)) 25/10/2011

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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 restrictions for one child do not impose similar restrictions on other children (NMS 10.4)  ensure compliance with the home's policies and procedures; this is with reference to specific incidents (NMS 21.2)  ensure that the induction training given to staff equips them with the knowledge that reflects the policies of the home, with particular regard to safeguarding (NMS 18.1)  ensure that regular monitoring of all records kept by the home identifies patterns and trends (NMS 21.2)  ensure that managers are clear about their roles and responsibilities and the lines of accountability are clearly defined. (NMS 21.4)

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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

Young people gain emotional stability from staff, who help them understand the impact of the difficulties on their lives. Some young people are becoming increasingly independent. They spend time with peers outside the home and school to broaden their social network. Young people are given new opportunities, including a group holiday to different parts of the country. This incorporated new travel experiences for many young people, which they recall enthusiastically. Young people are supported well with contact arrangements. Staff provide travel and supervision for contact with family and friends, and young people are supported well with their emotions and feelings surrounding this.

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Outcomes for children and young people

Young people attend schools both locally and at the neighbouring school owned by the organisation. Staff support for young people remains high and most young people attend regularly. Some young people achieve well at school and benefit from extra-curricular activities after school, including sport. Some young people have spent time in the local village after school. Staff have helped them to build relationships with peers and residents to encourage positive engagement within the community.

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Outcomes for children and young people

Young people gain some practical life skills at the home. Education and community meetings take up a large part of the day, leaving little room for helping with chores and gaining practical life skills. Meals are taken at the table and there are other foods freely available. Young people are able to make snacks when they are hungry. However, there are areas of the house that they are unable to access. Young people report that this is tedious and impacts on their independence.

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Quality of care

Young people have strong relationships with staff; these are well established and provide attachment and help young people feel secure. Staff provide clear boundaries in terms of general behaviour. Support for individuals is high, leaving little room for unsupervised behaviour or disagreements between peers. The community routines mean that any issues that arise are addressed daily in house meetings or individual child-focused meetings.

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Quality of care

Young people are encouraged to put forward their wishes and feelings. Staff listen to their points of view and are clear about why they cannot always fulfil these. The staff team makes decisions carefully and considers the community as a whole. There is a procedure for making complaints, and several young people report that they have been offered this opportunity by senior staff.

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Quality of care

There are several links to services to meet young people's psychological needs and these form part of the therapeutic approach. The staff team are multidisciplinary with specialist skills to help young people address the behaviours and patterns that cause them difficulty. Health appointments and medication arrangements are facilitated and organised well by staff. Placement plans detail all health needs and show clearly how these continue to be addressed. This ensures that young people’s individual health needs are all addressed. Risk assessments identity any high risk behaviours, and this helps young people and staff maintain and understand safe boundaries for individuals.

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Quality of care

Each young person's unique background is detailed in placement plans and understood by staff. However, there are instances where young people require more support to ensure they respect one another's differences. Staff are fully aware of this but do not report on specific incidents. This has resulted in some young people who feel that such issues are not always properly addressed.

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Quality of care

The educational achievement of young people is promoted well. Staff work with providers to ensure that barriers to attendance are reduced. Staff have built effective working relationships with providers by meeting regularly with them. Schools are invited to child-focused meetings held at the service. This approach ensures that all adults working with young people share agreed goals. This has resulted in young people who attend school regularly and make positive achievements.

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Quality of care

Young people live in a home that is well maintained by staff. The staff run the large house well. Clear task management has resulted in a clean, comfortable environment that resembles a welcoming family home. The general atmosphere is one of trust, bedroom doors are not locked and young people report that their belongings are safe. There are, however, some restrictions on domestic areas imposed on young people due to the behaviours of others.

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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 report that they generally feel safe at the home and appear to be relaxed and comfortable. The atmosphere is calm, and young people's personal space and personal belongings are respected. Young people rarely go missing from the home, although, at times they leave the premises and visit local areas when this is not agreed. However, they are protected by sound procedures and practice when they do so and this helps keep them safe.

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Safeguarding children and young people

The home is physically safe and secure. Doors are locked and all visitors are checked for identity and chaperoned around the house. The environment is maintained well and safety checks ensure that equipment and heating systems work safely. Fire prevention equipment is in place and checked annually. The manager has confirmed that fire drills are held at suitable intervals. However, the fire drill records were difficult to track and not available during the inspection. Additionally, the monitoring of these records by the manager was not up to date as required by the regulations. This compromises children’s safety.

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Safeguarding children and young people

There are child protection procedures that guide staff's practice to ensure that young people are protected from significant harm. These include written policies and induction training modules which cover this area. Some staff are clear about what to do in the event of an allegation or incident. However, newer staff have not yet been able to access training and are not clear about the procedures set out in the home's policies. This compromises children’s welfare.

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Safeguarding children and young people

In addition, policies to address discrimination or bullying are not always followed. There are instances in which discriminatory remarks have been used and while this has been challenged by staff, there is no record or log of these events, making monitoring difficult. The therapeutic routine of the home means that all such incidences are addressed in daily meetings. This process is valuable and helpful to some young people. However, there are those who feel that these issues are not fully addressed and that discrimination is not always vehemently challenged. Other behaviours are challenged by staff, who promote positive behaviour and understand how to manage heated situations.

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Safeguarding children and young people

The nature and complexity of some children’s history means that at times restraints are required. Physical restraints are only conducted to keep children, peers or staff safe. The records of these restraints and numbers of incidences are generally checked by the Registered Manager. However, there is a recorded entry made several days after the restraint. This compromises children’s safety.

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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 a newly registered manager in post who was previously a senior member of staff. Young people benefit from quality time with the manager, who maintains a shared key worker role. However, this has resulted in roles and accountability in management being blurred. The Regulation 34 monitoring does not sufficiently evaluate practice. Therefore ongoing compliance with regulations and ensuring that young people’s views are consistently represented and inform daily practice, are not monitored effectively. Management support is also provided by a second assistant director who has a clinical lead and maintains some areas of record keeping including safety checks. Overall, this is not clear and does not ensure that records are monitored thoroughly and fully support children’s welfare and safety.

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Leadership and management

External monitoring is provided and generates reports covering most requirements. Children are consulted with during these visits; however, the reports lack depth and detail, and consequently do not actively improve outcomes for children. The management concerns raised during the inspection were given immediate consideration as the service strives hard to raise the quality of the care they provide. The service has made attempts to act on recommendations raised previously. However, two of the areas identified for improvement are similar to the previous inspection and have not been fully addressed.

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Leadership and management

There is a development plan for improvement and future growth. These are both evident in relation to improvements to the interior environment from which children clearly benefit. The home is resourced adequately to meet the needs of the young people cared for. Numbers of staff are sufficient and new staff have been recently recruited by the service. They have begun a programme of learning on the therapeutic model used and induction to the Children and Young People's Workforce Diploma. There is a continuous commitment to staff's professional development to develop practice, knowledge and therapeutic skills. However, basic knowledge of the written safeguarding policy is poor, resulting in several staff who are unclear about how to fully protect children’s welfare.

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Leadership and management

Staff work hard as a cohesive team; their roles are challenging, and day and night shifts are busy with domestic tasks managed efficiently. Staff are dedicated and enthusiastic about their busy roles. There are a number of new staff, and reports from outside professionals say that staff changes can at times be unsettling for children in long-term placements. This impacts on young people’s continuity of care.

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Leadership and management

Records are stored securely and confidentially. Placement plans compiled by the service are of a high standard and provide concise and up-to-date information. The therapeutic ethos of the service means that many issues are addressed on a daily basis with staff and young people. However, there are incidents that are not reported on and therefore some specific incidents are difficult to monitor and evaluate the impact on young people. This has left some issues unresolved for young people, who are not happy with the outcome.

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Leadership and management

Overall, while outcomes for young people are good there are several shortfalls in both safeguarding and leadership and management. Staff, young people and authorities are clear about objectives of the therapeutic community and aware of its benefit to young people. The senior management of the organisation oversees the quality of the care provided and looks at the roles and responsibilities of the management team. However, this has not provided an objective picture of the day- to-day management of the service or enough clarity about the management roles. This has resulted in some areas of monitoring, record keeping and induction that need addressing in order to fully safeguard young people and improve the quality of their care.

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Leadership and management

Equality and diversity practice is satisfactory .

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