Children's Home run by Milestones Care Homes Ltd in Wirral

Unique reference number SC065780 Inspection date 31/08/2011 Inspector Chris Scully Type of inspection Full Provision subtype Children's home

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Date of last inspection 13/12/2010 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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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 cares for up to three children from six years to 17 years old with emotional and behavioural difficulties. It is owned and managed by a limited company.

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Overall effectiveness

The overall effectiveness is judged to be satisfactory .

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Overall effectiveness

Young people are happy and receive highly personalised care which meets their individual needs. They are provided with clear information about their care and the options available to them. Young people are able to make informed choices about the opportunities they receive. Consequently, young people are able to make good progress in all aspects of their lives. Social workers are very complimentary about the care and support young people receive. They say that the home provides a stable, supportive environment and that staff's consistent approach to managing challenging behaviours has had a positive impact upon young people. Young people enjoy positive relationships with staff and feel safe and secure. Effective safeguarding procedures mean young people are protected from harm.

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Overall effectiveness

Young people are consulted on all aspects of their care such as activities and menus. They enjoy a wide range of healthy meals and are becoming accomplished bakers. Young people feel valued as staff listen to them and take their views and feelings seriously.

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Overall effectiveness

The home is generally appropriately maintained. Risk assessments are in place and provide a detailed overview of the young people's needs and most of the potential risks, although some slip or trip hazards have not been identified. Monitoring of the home is not robust. As a result shortfalls in records and risk assessments such as fire safety and medication storage and recording have not been identified.

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Overall effectiveness

The home has a positive atmosphere where everyone usually gets along with each other. Young people are cared for by vetted, experienced and mainly qualified staff. Appropriate training opportunities means staff are able to keep up-to-date with their training needs and extend their current skills and knowledge. Staff are very supportive of young people's education and health needs.

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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) ensure there are suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home in particular the safekeeping and recording of administered medication (Regulation 21 (1)) 28/09/2011

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Reg. Requirement Due date

(2001) consult with the fire and evacuation authority and take adequate precautions against the risk of fire in particular the wedging open of fire doors (Regulation 32 (1) (a)) 28/09/2011

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Reg. Requirement Due date

(2001) ensure the person carrying out the visit prepares a written report on the conduct of the home and a copy of this is provided to Ofsted and the registered manager of the home (Regulation 33 (4) (a) (b) (c) (5) (a) (b)) 28/09/2011

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Reg. Requirement Due date

(2001) ensure there are appropriate systems for the monitoring of matters set out in schedule 6 at appropriate intervals in particular the reviwing of specific records. (Regulation 34 (1) (a) (3)) 28/09/2011

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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 risk assessment of the home clearly identifies any potential sources of harm and how these are to be reduced in particular the issues in the bathrooms (NMS 10.8)  ensure there is an emergency escape plan which all staff and young people are familiar with and have practiced in particular young people who are new to the home (NMS 10.9)  ensure all existing care staff have attained a minimum level 3 qualification (NMS 18.5)  ensure entries in records are legible, clearly expressed and are clearly recorded in a way in which they will be helpful to young people. (NMS 22.4, 22.5)

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Outcomes for children and young people

Outcomes for children and young people are good .

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Outcomes for children and young people

Young people have a positive view of themselves, which includes a secure understanding of the background and family ties. They maintain positive relationships with those people who are important to them because these arrangements are effectively managed. Young people meet regularly to spend time with their friends both in the community and at the home. This is important to the young people and has a positive effect upon their self-esteem. Contact with family is effectively and sensitively supported by staff who are aware of the consequences for the young people should this not take place. Effective strategies are in place to minimise the effect of any disappointments young people should experience if a planned visit does not take place.

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Outcomes for children and young people

Young people enjoy healthy lifestyles and are always encouraged to take an interest in looking after their own physical and emotional needs. Young people are aware of their own health needs and the agencies which can offer them support and guidance such as Child and Adolescent Mental Health teams (CAMHS). Young people are engaged in a wide range of activities, which enhance the health and physical well- being such as kayaking, adventure playgrounds, football and cricket. Young people’s health needs are met well as staff are attentive to their medical needs and ensure that they receive their medication at the appropriate times. However, medication records are not always completed at the time the medication was given, in particular controlled medication.

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Outcomes for children and young people

Young people enjoy a wide range of healthy, nutritious meals and snacks. Young people enjoy the opportunities to cook and prepare meals with staff. Social worker’s comment upon young people's new found confidence in cooking and eating healthily. This has been supported by the home achieving the Healthier Home Award. Young people enjoy the opportunities to grow vegetables such as potatoes in the garden. They learn how to care for the plants and enjoy the spoils of their labours when they harvest their crops and use them in their evening meal.

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Outcomes for children and young people

Young people are making good progress with their education. Young people's attendance is good and they have recently received an award from school for this. Young people say that they do go to their placements, but do not like getting up in the morning. They readily engage in activities with staff such as searching the night sky for constellations, calculating their scores at snooker and creating gardening scrap books. This effectively enhances their opportunities to learn about the world around them and develop their mathematical skills.

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Outcomes for children and young people

Young people are being well prepared for adulthood. This is achieved as young people undertake more tasks for themselves, for example, helping with the laundry, preparing meals and tidying their bedrooms. Young people are developing budgeting skills as they manage their own finances and understand the need to save for more expensive items, such as computer games. Young people are able to travel independently to visit friends on public transport.

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Quality of care

Young people enjoy positive and constructive relationships with staff. Young people say the staff are 'great' and they feel able to talk to them and know that they are listened to. Staff talk fondly about young people and have their best interest at the heart of everything they do. These positive relationships enable young people to feel safe in their care. Young people engage in friendly banter with staff and enjoy spending time with them. Young people value the support and guidance provided although they may not have been appreciative of this at the time. One young person wrote a letter to thank the staff for their support and said 'I have achieved so much and come so far, now I can face the world with my head held high.'

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Quality of care

Young people feel valued as systems for consultation are effective and their views are integral to the provision. Young people are always listened to and their feelings are considered when making decisions about activities, menus and décor of the home. They are confident to put forward their views and wishes such as the activities they would like to participate in. Young people are made aware of why such requests, such as going to a boxing club, are not appropriate at this time. Young people are aware of the home's complaints system and know that their concerns will be addressed.

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Quality of care

Young people continue to make good progress in all aspects of their lives due to staff's excellent understanding of their needs and the highly personalised care which is designed to meet their specific and individual needs. The home works closely with the placing authorities to ensure young people's needs are met well. Social workers are complimentary about the home. They say that staff are proactive in sourcing information and speaking to others who are involved with the young people. Social workers are pleased with the communication between themselves and the home and feel that this contributes to the positive outcomes for young people. Statutory reviews take place within prescribed timescales and young people have a choice of whether to attend these. Young people are able to contribute to their future plans and are kept fully informed of the outcome of these meetings. Social workers say that because of staff's commitment and support young people have 'turned their

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Quality of care

Young people's health needs are effectively managed. Effective relationships with the looked after children nurse means staff are able to talk to them about young people's health care needs and seek additional support and guidance if necessary. Young people receive good care when they are unwell. They are registered with the health care professionals, such as the doctor and dentist. Young people are able to make informed choices about their own health. This is because staff actively promote healthy lifestyle choices by providing young people with information on topics such as smoking and sexual health. Young people's privacy and dignity is respected, as staff sensitively handle young people's personal needs.

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Quality of care

Young people's education is effectively supported by staff that have high aspirations for young people. This is supported by the effective communication systems between the home and the educational placements. Staff ensure the placements are aware of any incidents which may affect the young person's ability to engage that day and to consider strategies to support them during this time. Staff are proactive in sourcing appropriate education for young people and welcome the opportunities for young people to meet with the staff before they start. Daily routines support young people's attendance and ensure young people are equipped with the necessary tools to engage in the various learning opportunities.

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Quality of care

Young people are engaged in a wide range of enjoyable activities. Young people's interests are carefully considered and staff actively seek activities to support this, such as working with animals, kayaking and cars. Activities are designed in consultation with the young people and they then choose as to whether to participate or not. Young people enjoy cultural evenings where they explore foods from different countries and consider the related way of life. Young people talk enthusiastically about their football club and how staff take them to their training session.

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Quality of care

The home is warm and welcoming. It is situated in a residential area close to shops and other local amenities. Most areas of the home are usually appropriately maintained. The design and layout of the home meet the young people's needs and generally provides a homely environment.

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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 are safeguarded as staff have a secure understanding of the home's safeguarding procedures. This means they are able to take swift appropriate action should they have any concerns about a young person. This is further supported by the home's safeguarding policy and training provided to staff. Staff's positive relationships with social workers means they are able to quickly identify any issues which may impact upon a young person's safety and well-being.

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Safeguarding children and young people

Young people do not go missing from care. Social workers say that the home has been proactive in eradicating this issue for young people who previously went missing. However, clear policies and procedures are in place should this occur which means should a young person go missing, they can be quickly located and returned home safely.

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Safeguarding children and young people

Young people are generally well behaved, they are polite and courteous to staff and visitors. Young people say they are aware of the house rules and feel that these are 'ok'. Young people are occasionally sanctioned for incidents of poor behaviour and usually make a comment on these in the record book. Staff talk to the young people about these incidents which enables young people to consider their actions. Young people are aware that they may be physically restrained by staff. They are clear on the reasons and procedures for this and say 'staff follow the rules'. Records of restraint are generally well maintained, however on some occasions it is not immediately clear as to which member of staff actually restrained the young person.

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Safeguarding children and young people

Young people's individualised risk assessments help to keep them safe both in the home and in the community. Risk assessments are in place for the home; however the weekly health and safety checks have not identified possible tripping hazards and maintenance issues. These include the discolouration to some parts of the bathroom wall, uneven flooring in the bathroom, and worn flooring on the landing. Fire drills take place on a monthly basis. However, a drill has not been undertaken since a new young person was accommodated. Staff have discussed the procedure with them at key worker sessions. A fire risk assessment is in place and states that the fire doors on the ground floor are held open during the day. However this has not been agreed with the fire authority and may mean young people are not fully protected.

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Safeguarding children and young people

The home is secure which prevents unauthorised persons gaining access to the home. Recruitment and selection procedures ensure suitable staff are employed to work with young people. Safeguarding checks are undertaken prior to any member of staff working with young people. Visitors to the home are suitably vetted and are required to sign in and out of the premises.

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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 new Registered Manager is highly committed to improving upon the outcomes for young people and this has been their main focus over the last few months. As a result young people are happy and settled in the home. The Registered Manager has addressed the issues from the previous inspection which has improved upon the home’s systems, such as staff recruitment, induction and supervision. This has improved upon the safeguarding procedures and support provided to staff. Staff say that they have very good support from the manager. Staff say they work well as a team and now have a more consistent approach with the young people, which has improved upon the outcomes for them.

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Leadership and management

Monitoring systems for the home are not effective. Regulation 33 visits take place on a monthly basis. However, the provider has failed to provide a written report to the Registered Manager and Ofsted for some considerable time. Reports made available during the inspection did not identify any of the shortfalls raised at this inspection. The manager carries out regulation 34 reports each month. While these reflect the matters to be monitored in schedule 6 in relation to each young person, the Registered Manager has not examined the records in relation to this. As a result a number of shortfalls within the records have not been identified which impacts upon the care provided and the home’s ability to demonstrate continuous improvement. For example, there are no systems in place to check the medication record book or cabinet to ensure the correct numbers of tablets are in stock; resulting in confusion

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Leadership and management

as to the actual numbers of tablets in stock and highlighted a lack of robust recording of administered medication. Most records and documentation are generally appropriately maintained. The Registered Manager has responded positively to these issues and has already begun the process of addressing these, such as instigating weekly checks on the medical cabinet. A development plan in place for the home, which outlines some of the areas for improvement over the next year.

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Leadership and management

The provider meets the aims and objectives of the Statement of Purpose and is in the process of updating this. The young person’s guide provides clear information to young people and their families about the care and support they can expect to receive. This combined with the Statement of Purpose provides transparency for young people, their families and placing authorities.

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Leadership and management

Young people are looked after by a staff team who have a range of skills and experience. The staff team reflect the cultural needs of the young people and provide both positive male and female role models. Most staff hold an appropriate childcare qualification. All staff have equal access to training which keeps them abreast of current legislation and good practice guidance. Systems are in place to ensure the appropriate agencies are informed of any significant events within the home.

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Leadership and management

Equality and diversity practice is good .

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