Atkinson Unit

Unique reference number SC046276 Inspection date 23/05/2012 Inspector Michelle Oxley / Andrew Hewston Type of inspection Full Provision subtype Secure Unit

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Date of last inspection 18/11/2011 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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Brief description of the service

This secure unit is managed by a local authority. The unit is registered as a secure children’s home and is approved by the Secretary of State to provide secure care and accommodation. The unit is currently providing placements for up to 10 young people.

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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 Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be good .

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Overall effectiveness

The home is effectively managed and operates positively to achieve good outcomes for young people. The service is rigorously monitored and adjustments made to facilitate improvements where shortfalls are identified.

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Overall effectiveness

Staff demonstrate commitment to their role and endeavour to establish positive relationships with young people. The quality of relations between staff and young people is very good. Young people express positive views about the support they receive and unanimously state that they feel safe and protected in the home.

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Overall effectiveness

Young people are supported to address the factors that have led them to be at risk through a highly individualised approach. Good written documentation is in place to support and plan for care, resulting in placements that produce positive improvements and outcomes for young people.

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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

 increase the level of work around transition planning to support young people when they move from the home (NMS 23.1)  ensure that young people are provided with full information following every complaint investigation (1.6)  ensure that an accurate and comprehensive record is maintained in respect of all medication (NMS 6.15)  ensure that the registered person has oversight of recruitment records for all staff working at the unit, including involvement in reaching decisions as to who is to be appointed and the circumstances in which the application should be refused in the light of any criminal convictions (NMS 16.5)  ensure suitable facilities are available to facilitate improvements in the approach to personal searches of young people. (NMS 10.2)

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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

The home has developed a range of good proactive practices that help to develop young people’s self-esteem and a positive view about themselves. This is reinforced by a staff team who consistently promote positive aspects of young people’s time within the home. Young people are subsequently able to discuss their own improvements and achievements such as controlling their anger. Families also report that young people have improved, with one record stating that they had seen ‘a big change in their ways and their attitude had improved.’

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Outcomes for children and young people

Some excellent work has been completed with the new social worker who supports young people’s development. Young people have been helped with examining their own histories and what changes they may want to make in the future.

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Outcomes for children and young people

Young people develop an awareness of how to lead a healthier lifestyle and this is encouraged through both the residential aspect of the home and through education. Issues such as sexual health, and drug and alcohol awareness, are tackled within learning and social environments and information on these areas is available to young people. Young people’s mental health is supported through regular meetings with psychological professionals and additional complementary therapies further enhance young people’s awareness of their emotional development.

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Outcomes for children and young people

Young people are helped to understand their own behaviours through an approach which is therapeutic rather than punitive. Young people are encouraged to talk about problems and behaviours and develop a greater understanding of their own emotional responses. An incentive scheme operates in line with the therapeutic approach, rewarding and reinforcing positive behaviours.

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Outcomes for children and young people

Young people achieve and develop within education, with some progressing significantly in their ability to read and as a result engage successfully within lessons. The education and residential staff work together to promote learning although there is currently a reluctance to attend on a regular basis. This is being responded to through increased rewards, but may require a more fundamental examination of the reasons behind the current group’s resistance to engage in education.

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Outcomes for children and young people

A well organised system of contact means that young people and their families are fully supported with visits to the home. The contact area is acceptable, but imaginative use of other areas around the home further enhances visits. Plans are in place to further enhance contact arrangements including a larger contact room and a new telephone system. Contact arrangements are clear within young people’s files and well known by both the young people and the staff, to ensure that there are no frustrations relating to who young people are able to talk to.

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Outcomes for children and young people

Positive transition arrangements help to support young people’s movement from the home. This is helped with proactive development of young people’s independence skills such as laundry and cooking. Exit planning documentation is in place although this is sometimes basic and does not clearly show the extent to which a range of different parties involved have worked together to support young people.

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Outcomes for children and young people

Throughout young people’s time at the home they learn about their ability to effect decision regarding their care. This is completed through the regular key working sessions and weekly young people’s forums, where issues are then subsequently raised within managers’ meetings.

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Quality of care

Young people talk positively about the staff team who work with them and the way that staff help to support their development. Young people are especially complimentary about their key workers stating that they ‘really get to know you and help you.’ Full and thorough placement planning is supported by information from key workers and young people. Staff focus on young people’s views, wishes and preferences. Information gathered prior to admission is used to inform the initial care provision. This is quickly reviewed with young people to make sure it meets their presenting needs. Placement plans link well to behaviour management strategies and support young people’s care.

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Quality of care

Recordings of young people’s group meetings are thorough and show information being shared appropriately. The ability of young people to attend part of the management meeting shows the senior staff’s commitment to supporting young people’s views and wishes. They are offered an advocate or independent listener if they wish to raise concerns external to the home. Additionally, they have regular opportunities to speak to the visitor who monitors the practice of the home in line with Regulation 33. There is a complaints process, which young people are fully aware of. Where complaints are made, full and thorough investigations take place. If complaints are made internally then a clearly recorded response is given to the young person. This practice is not consistently applied to complaints that have been made outside the home.

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Quality of care

A good range of dedicated systems ensures that young people’s health needs are responded to on admission to the home. Checks relating to their eyes and teeth are completed swiftly and regular appointments are available with other health professionals, including doctors, nurses, psychologists and psychiatrists when necessary. Training in first aid is regularly updated and all staff receive training in medication administration. The majority of medication records are fully completed although there are occasional dates where staff have not signed following administration and this does not appear to have been picked up during monitoring. A prescribing error led to one instance of medication not being available to a young person overnight. Young people are supported through drug withdrawal and smoking cessation.

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Quality of care

Young people are involved with a range of enrichment activities that are well organised in advance. All staff are involved with offering differing activities to the young people in line with their specific skills. The enthusiasm of some staff to ensure that young people are involved with differing activities helps to develop positive relationships between the group as well as the staff team.

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Quality of care

All staff support young people’s education and personal education plans form part of young people’s development within the home. Effective links are in place between education and residential staff, with concerns or praise being shared to ensure a consistent approach. This is specifically noted with relation to behaviour management planning.

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Quality of care

An awareness of the cultural needs of individuals forms a high priority in the work completed with the young people. Cultural issues are addressed in daily living and staff are able to discuss how diverse needs can be met. Staff also enjoy learning from young people, about their culture and individual preferences. This culture of enquiry promotes ever-increasing knowledge, which is used to develop ongoing improvement. A new poster in the dining room relating to racism has created a wealth of discussion from the young people.

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Quality of care

The home is well looked after by both staff and young people. It is clean and improvements are constantly being examined. Both lounge areas have recently received new furnishings although these have had a mixed response from the young people. The overhauling of the air conditioning has improved the living environment and staff state that this has had a positive effect on the young people. Bedrooms are personalised and young people are able to have an influence on colour schemes as well as putting up their own pictures and posters. Health and safety checks are regularly completed within a well ordered and robust system. Since the last inspection on two occasions young people were able to access restricted areas. These have been fully responded to and additional security measures have been put in place.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people without exception say that they feel safe and protected in the unit. In some cases young people express their vulnerability in the wider community and understand that the security provided by the home serves to protect them and support them to address their problems.

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Safeguarding children and young people

Young people benefit from the use of mobility which is used to good effect, helping to develop skills in preparation for a return to the community. Mobility is carefully risk assessed in relation to planned destination and the needs of the young person concerned. Since the last inspection there have been two cases of young people going missing when on mobility out of the home. In both cases the young people were quickly returned, demonstrating the home’s effective working relationship with the police. Policy and procedure have been amended in light of these occurrences. Overall the use of mobility remains positive in terms of the benefit gained by young people.

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Safeguarding children and young people

A good level of commitment is demonstrated in relation to reducing the number of physical interventions. Restraints are regularly monitored in relation to their overall numbers, patterns and themes as well as a review of CCTV footage, involving scrutiny by the Local Authority Designated Officer (LADO). Although patterns of restraint vary in numbers from month to month, there is a downward trend for individual young people. This demonstrates the team’s ability to work constructively with individuals in order to develop alternative strategies to engage young people and to manage their behaviour without intervening physically whenever possible.

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Safeguarding children and young people

Ongoing work relating to the reduction of physical interventions is evidenced through a new system to record restraints which promotes non-intervention by requiring a more thought provoking system of recording. The development of new written positive handling strategies provides holistic information to staff, including a rational for emotional responses and patterns of behaviour. These provide a greater level of understanding of young people’s needs and equip staff with behaviour management strategies as an alternative to physical interventions. In addition, improved monitoring systems now provide more detail around the individual circumstances of each restraint leading to more rapid intervention and as a consequence reduction in numbers of restraints for individuals have occurred at an earlier point in time.

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Safeguarding children and young people

Overall the approach to behaviour management has developed into therapeutic and restorative approach enabling young people to understand their responses and develop their own skills to interact in a more constructive manner. This approach is particularly effective in relation to counter bullying where staff work closely with young people to discuss and diffuse potentially volatile issues. Staff are deployed effectively to deal with potential incidents. A series of risk management strategies ensure that staff work proactively with small groups of young people to eliminate potential bullying. As a result young people feel protected from bullying and do not identify this as a problem.

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Safeguarding children and young people

Arrangements and procedures for recruitment and vetting staff help to prevent employment of unsuitable people. Staff recruitment records are comprehensive and contain all the required information. Some staff work shifts at the home through the local authority’s team of bank workers, to cover staff shortages. Some staff from this team have also obtained permanent positions at the home. All of these staff are subject to the same vetting procedures as other staff but in their case, the Registered Manager has not has been involved in the recruitment process and therefore has no knowledge of the vetting information for each of these employees. Therefore he does not have a comprehensive oversight of the background and history of all of the staff team.

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Safeguarding children and young people

The key objectives of the home are to safeguard young people so that they can be helped to confront, understand and try to overcome the problems which have led to them being at risk. This is achieved by robust systems to protect and promote the welfare of young people along with positive support and security. The team responds effectively and demonstrates an ability to ensure that new methods of working with young people are adopted in response to emerging issues. This has included developing an enhanced approach to working with young people who have been sexually exploited. Young people are further protected by a robust approach to the investigation into allegations of suspicion of harm. There are good links with the LADO and the Registered Manager is a member of the Local Safeguarding Children Board.

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Safeguarding children and young people

Clear written plans to identify and manage risk are in place to protect young people. A system is in place to screen young people for particular vulnerabilities on admission. Assessment and monitoring are ongoing through weekly meeting with other professionals and key workers to ensure that individual risks are highlighted and measures put in to place to support and manage these. Written records are updated in line with changing needs and developing strategies; these ensure that the team have up-to-date information to enable them to manage risk consistently and in line with agreed approaches.

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Safeguarding children and young people

Searches of young people’s rooms and possessions are carried out with sensitivity and according to the risks presented by the young person. Young people say that room searches are usually conducted when they are at school and that care is taken with their possessions. Personal searches are carried out in line with written procedures. Young people are well supported by same sex staff through this sensitive process and say that staff are respectful and try to ensure that the process is as dignified as possible. However, searches are currently conducted in the medical room which, because of its size, is not conducive to the process, leading to cumbersome arrangements for the removal of clothing under a gown. Staff are unavoidably closer to the young person than would be desirable due to space limitations. There are also no facilities for personal searches where risk assessment establishes that line of sight searches are not required.

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Leadership and management

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

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Leadership and management

The home is effectively and efficiently managed by the Registered Manager. The management team model a strong commitment to meeting the diverse needs of all young people which has a positive impact. The staff team express respect for manager’s drive and commitment to developing the service and the ability to introduce new ways of working in response to legislative changes and the presenting needs of young people.

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Leadership and management

There is a strong commitment to continuous improvement of practice. The home’s development plan sets out realistic goals which aim to drive the service forward. Areas of weakness are identified and targeted for improvement. Managers take a proactive approach to ensuring that the development aims are monitored through a series of meetings that tracks progress. Young people are aware of the development plan and have been provided with a child-friendly copy to ensure that they are aware of the future direction of the service.

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Leadership and management

Robust systems for monitoring the performance of the service are in place. These serve to inform managers of emerging trends and patterns and are used to good effect to create new improvement strategies. For example, improvements in the acquisition of services to support the mental health needs of young people have created a more informed approach to working holistically with the diverse needs presented by young people. Complaints and concerns are monitored and addressed by managers in a timely fashion.

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Leadership and management

The home meets its stated objectives as set out in the Statement of Purpose. Young people, staff and the placing authority are clear about the aims and objectives of the home and the services and facilities provided. Managers and staff maintain positive working relations with external professionals such as the police, health professionals and local authorities. Communication with external professionals is good and managers ensure that all significant events are recorded and the information is promptly shared with other relevant individuals. Key workers link effectively with relevant professionals ensuring that reviews and visits from external professional occur in a timely fashion.

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Leadership and management

The staff team are highly motivated and demonstrate a strong commitment to providing positive support for young people. They receive good training opportunities to help them to develop their skills. Managers ensure that staff receive all mandatory training. In addition, they ensure that training reflects the required support needs of young people and incorporates current issues of national concern, for example, new training introduced regarding sexual exploitation.

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Leadership and management

Staff are supported by managers through supervision which enables them to carry out their role effectively. Staffing levels are sufficient to meet the current needs of the young people living at the home. Since the last inspection an ‘employee of the month award’ has been introduced. All staff, including ancillary staff can be nominated; the award gives recognition to those who have demonstrated a strong commitment to the unit and hence benefited young people.

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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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