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

Unique reference number SC065780 Inspection date 06/03/2012 Inspector Chris Scully Type of inspection Interim Provision subtype Children's home

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Date of last inspection 31/08/2011 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 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

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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Progress

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

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Progress

The home was last inspected in August 2011, when the overall effectiveness was judged to be satisfactory. Following the inspection four statutory requirements were issued. These related to; the monitoring of the home, the administration of medication and fire safety. Four recommendations were also raised regarding; risk assessments, emergency evacuation, staff qualifications and entries in records being legible and clearly expressed.

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Progress

Young people's health promotion has significantly improved. This is because of the considerable improvement for the systems for the recording, administering and storing of medication. Staff have completed a level two qualification in the safe handling of medication. Staff say this has been very beneficial as it has effectively challenged their consciousness with regards to medication. This has enabled them to instigate new procedures regarding the administration of medication. This means medication administered to young people is clearly recorded. A revision of all policies and procedures relating to medication has enhanced the systems for storing and checking the medication within the home. The instigation of weekly checks of the medicine cabinet and medication records ensures they remain accurate. Improved systems are in place for the safe disposal of medication. Consequently, medication which is no longer needed is not stored within the home. The creation of a handover

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Progress

sheet for new carers has enhanced young people’s health and well-being. This informative document provides carers with detailed information regarding young people’s medication, including how it should be administered. This effectively promotes continuity of care for young people.

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Progress

Young people are kept safe as staff ensure all fire doors are not held open. The home are consulting with the fire authority to ensure all fire prevention strategies are effective. Revised fire risk assessments clearly identify any safety issues. This includes potential sources of ignition and how these hazards have been minimised. Staff say this has enabled them to consider the amount of combustible material within the home and how to effectively minimise any potential hazards. Young people are able to keep themselves safe as they are aware of the emergency evacuation procedures. This is because fire drills are conducted on a regular basis.

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Progress

Monitoring of the home by the independent person and Registered Manager has improved. Reports clearly outline any shortfalls and the action required. This has enabled the home to make the improvements outlined in this report. Reports compiled by the independent person are made available to the Registered Manager, staff and Ofsted. These reports enable the manager and staff to consider any shortfalls and how these are to be addressed. The Registered Manager is proactive in dealing with the issues from the last inspection and visits by the independent person. Monthly monitoring by the Registered Manager is effective and contributes well to the ongoing development of the homes systems and outcomes for young people.

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Progress

Young people are cared for in a warm, homely and safe environment. This is because potential risks to young people are minimised or eradicated. The bathroom has been redecorated and there is no discolouration to the walls. Young people are reminded to open the window after bathing or showering to prevent a build up of moisture in the room. The hallway has been redecorated and new carpets have been fitted. Young people are pleased with the décor and discuss their future plans for the lounge area. Young people are taking responsibility for the décor in the lounge. They are encouraged to budget for all essential items and to help with the decorating. This ensures they are fully consulted and allows them to develop future life skills. Although, young people have some very clear ideas on what the majority of the budget should be spent on, such as a new television. Comprehensive risk assessments are in place for all areas. Young people are kept safe as weekly and

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Progress

monthly checks are carried out to ensure they remain safe and suitable. Young people are encouraged by staff to help address minor issues, such as replacing light bulbs.

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Progress

The home has sourced appropriate training for those staff who do not currently hold a level 3 qualification. Staff are enrolled on courses and are about to commence their training. Entries in records and documentation are much improved. This provides young people with a realistic view of their time here. However, the recording of sanctions is not as robust. This is because on occasion insufficient information is recorded about why the sanction is imposed, which can lead to some appearing overzealous. Although, this is clarified within the incident record, there is not always a clear audit trail and there is limited reference to the effectiveness of the sanction.

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Progress

Young people say they are fully consulted about what happens in the home. They are keen to talk to inspectors to discuss their concerns regarding the kitchen being locked of a night. This impacts upon their ability to get a drink during the night. Discussions with the Registered Manager and staff show this has recently been put into place due to the risks presented by the young people attempting to put on the gas and cooking during the night. This has not been fully risk assessed, though staff say they have verbally discussed this with social workers. However, there is no record of this. This may be interpreted as a restriction of young people's liberty.

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Progress

The Registered Manager and staff are highly committed to improving the outcomes for young people. Since the last inspection they have instigated many new policies and procedures which have improved upon the outcomes for young people in relation to their health, safety and well-being. This includes more in-depth care plans and monthly in-house reviews of young people's progress with young people. Staff are continuing to encourage young people to engage with educational programmes. Despite staff's efforts, some young people remain adamant that they are not going to attend. Staff are sourcing alternatives for young people through connexions and are actively encouraging young people to engage with the support agencies. Letters from young people who have recently moved on show how much they valued the input from staff. They say that 'they were not always easy to care for.' Young people say they will visit but, 'won’t be coming for tea when one member of staff is cooking

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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 entries in records are legible, clearly expressed and are clearly recorded in a way in which they will be helpful to young people, in particular the entries in the sanctions record (NMS 22.4, 22.5)  ensure physical restrictions on the normal movement within the home, such as locking the kitchen at night are only used when agreed with the responsible authority and, if appropriate, the parents. Such restrictions for one young person do not impose similar restrictions on other young people. (NMS 10.4)

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