Children's Home run by CareTech Community Services Limited in Staffordshire

Unique reference number SC005041 Inspection date 12/01/2012 Inspector Robin Whistlecraft Type of inspection Interim Provision subtype Children's home

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Date of last inspection 22/09/2011 Website: www.ofsted.gov.uk

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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 progress made by the provider since the last full inspection, identifies any further strengths, any areas for improvement and makes judgements as outlined in the Inspection of children’s homes – framework for inspection (March 2011).

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The inspection judgements and what they mean

Good progress The children’s home has demonstrated continued improvement in quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the large majority of recommendations that were raised at the previous inspection. Satisfactory progress The children’s home has maintained quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the majority of recommendations that were raised at the previous inspection. Inadequate progress The children’s home has failed to address one or more requirements and/or has not met the majority of recommendations and/or the quality of care and outcomes for children and young people have declined since the last full inspection.

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Brief description of the service

The home is registered to accommodate up to 10 young people with a range of disabilities including physical disability, learning disability and complex needs. The provision may be for either settled care or short-breaks.

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Progress

Since their previous inspection the service is judged to be making satisfactory progress.

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Progress

At the last inspection in September 2011, the overall quality rating for the home was judged as satisfactory with five requirements and seven recommendations for areas identified for improvement. The home has taken the outcome of the last inspection as an opportunity to review a range of its administrative processes. In that context the progress it has made is reasonable. The home has generally met the five requirements but it has not always used the regulations as a benchmark. Because of this the home has made errors. The home has addressed four of the recommendations in full, is well underway in addressing two more, and has only one still to fully address. The final recommendation will require some imaginative thinking and so a period of reflection on it is appropriate.

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Progress

At the last inspection, the home’s Statement of Purpose had several shortfalls. Since then the home has reviewed and revised the Statement of Purpose so that it now contains all the required sections. The home supplies its Statement of Purpose with a parents’ guide that contains additional details about permitted and prohibited sanctions within the home. This means that the information is there but not within the main document. To avoid confusion this information should also feature within the main Statement of Purpose as well as the parents’ guide.

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Progress

The last inspection identified that the Registered Manager did not have a routine process for monitoring statutory records and other matters. The Registered Manager has since introduced such a system, together with an associated recording system. This means that the manager will have a data source that, if necessary, will help identify improvements in the quality of care for the young people.

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Progress

The last inspection noted that there had been a lapse in staff supervision, and that the home needed to develop a staff appraisal and development process. Since then the home has expanded the number of senior staff who provide staff supervision, and provided supervisory training to them. Consequently, refreshed staff supervision sessions are underway, with a clear format for what should take place within supervision, and future sessions have been booked into the home’s diary. The new format now includes exploration of staff performance as a building block for a new staff appraisal system. Once staff have been introduced, through supervision, to the skills of self-assessment, the home has plans to introduce this staff appraisal system. The Registered Manager has already started experiencing the new appraisal system. This means individual and team performance will be enhanced.

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Progress

The fourth requirement at the last inspection related to maintaining records of measures of control and discipline in relation to each young person. The home does keep an individual record for each young person, about that young person’s behaviour during each staff shift. This record includes details of the circumstances and type of sanction used, if applicable. Therefore, the home has addressed this requirement. Recently, the home has focused on creating additional individual records that meet the higher expectations of the central record of all measures of control used for all young people in the home. Unfortunately, when revising the system the home has replaced the required central record of measures of control, for resident young people, with two hard back books used to audit the new children’s records. This system does not provide the required detail for a central record of the use of measures of control. The home does maintain a central record of the use of

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Progress

physical restraint in relation to young people receiving respite care, but on occasions the details of the specific technique used are insufficient; for example, ‘using necessary tools from Maybo’.

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Progress

The fifth requirement at the last inspection was for the home to consult the fire and rescue authority to ensure the adequacy of its fire precautions. The home has addressed specific shortfalls that the last inspection identified. The fire officer has visited and asked for a door seal to be replaced. The home has made this repair and is waiting for the fire officer’s report. There is a current fire certificate. The home’s maintenance man maintains a record of regular emergency lighting system checks. The fire detection and alarm panel has been checked and tested. These actions mean that the home has removed the potential risk to young people and staff.

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Progress

The first of the seven recommendations made at the last inspection was in relation to a need for parts of the home to be refurbished. Since then the home has refurbished the kitchen, one bathroom used by young people and had communal areas repainted. The home ensured that the contractors only carried out the work while the young people were at school. This meant that young people benefited from minimum disruption to essential routines and their need for familiarity around them.

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Progress

The use of photographs to reflect and celebrate events and achievements provide colourful displays, as does the extended display of achievement certificates. This means that young people benefit from a home that is better equipped, more pleasantly decorated, and which reflects their lives within it.

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Progress

The home has also fitted two track hoists as well as a bath lift. In one case the track hoist reflects good forward thinking by the home, providing an opportunity for familiarisation with the equipment before its anticipated future necessity. This provides an improved experience for a young person and builds upon a previous positive experience.

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Progress

The second recommendation was for the Registered Manager to enrol on a management training course within six months and obtain a relevant management qualification within three years. The home has started to address this and the Registered Manager is about to enrol on a relevant course. This means that young people will benefit from a home that has enhanced management.

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Progress

The third recommendation was for the home to ensure that young people, young people’s families, social workers and Independent Reviewing Officers views about care provided in the home are regularly sought. Since the previous inspection the home has started a series of surveys, and completed these for parents and social workers. Where returned surveys have included suggestions, the home has reviewed practices and made changes. This means that young people benefit from responsive care.

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Progress

Another recommendation was for the home to develop a culture that consciously promotes positive behaviour and ensure that staff understand it and implement it. A fifth recommendation was in relation to clear, fair, reasonable and generally understood sanctions and rewards. Since the last inspection the home has revised its Statement of Purpose to reflect these recommendations, and the home’s external line manager has led a staff discussion about the use of positive reinforcement. The home has consulted parents and social workers about revised behaviour management plans. The home rarely uses sanctions, but when it does withdraw an activity or item as a sanction, the item or activity is returned later as a reward for subsequent appropriate behaviour. Staff use diversion, distraction and praise as favoured ways of managing young people’s behaviour. Records illustrate how staff swap responsibility for specific young people in order to assist in reducing episodes

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Progress

of challenging behaviour. In these ways, young people benefit from measures of control that better suits their level of understanding and behaviour.

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Progress

The sixth recommendation was about records in relation to the return of medication and arrangements for when deliveries of prescribed medication are inadequate. The home now insists that the pharmacy’s representative, who collects the returned medicines, signs for the returned stock. This means that the audit trail is now complete. Since the last inspection a member of staff has spent time at the surgery of the prescribing doctor to review all repeat prescriptions to ensure that prescribed quantities of medicines match the pharmacy’s delivery schedule. This detailed work has since prevented any problems with shortfalls in delivered medicines.

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Progress

The final recommendation was in relation to involving young people, where practical, in the recruitment of staff. The home filled remaining vacancies before being able to reflect on the implications of this recommendation for the young people with learning and some physical disabilities that it cares for. Therefore, the home still needs to undertake some work in order to implement this recommendation.

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Progress

The home has continued to provide a good quality of care. Staff interact playfully with the young people, seeking to stimulate a positive response however small. Young people appeared relaxed in staff company, enjoying the interactions.

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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

17B (2001) ensure that within 24 hours of the use of any measure of control, discipline or restraint in a children’s home, a written record is kept for the purpose, including the prescribed details. This relates to both resident young people and those receiving respite care (Regulation 17B (3)) 29/02/2012

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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 the children's home has a clear Statement of Purpose which is available to and understood by staff and children and reflected in any policies, procedures and guidance. This is in relation to including additional information about measures of control in the Statement of Purpose as well as the parents' guide (NMS 13.1)  ensure appointees to the role of registered manager who do not have the management qualification enrol on a management training course within six months and obtain a relevant management qualification within three years of their appointment (NMS 14.3)  ensure the views of the child, the child’s family, social worker and Independent Reviewing Officer are sought regularly on the child’s care (unless in individual cases this is not appropriate) (NMS 1.4)  ensure, where practicable, children are involved in the recruitment of staff in the home (NMS 16.8)

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