Children's Home run by Friends Therapeutic Community Trust in Cambridgeshire

Unique reference number SC025733 Inspection date 08/11/2012 Inspector Stephen Halliley Type of inspection Full Provision subtype Children's home

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Date of last inspection 21/03/2012 Website: www.ofsted.gov.uk

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Brief description of the service

The service is registered for 17 placements with emotional and behavioural difficulties and or learning disabilities. The service provides a therapeutic programme and treatment for young men who engage in a structured programme detailed within the Statement of Purpose.

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Brief description of the service

The service is run by a community trust and caters for a specific age range and needs detailed within the Statement of Purpose. There are semi-independence bungalows in the grounds and a separate satellite service for those who require transitional accommodation before living independently. There is a wide range of facilities including on-site education and vocational workshops to support accredited work based learning courses.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality 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 outstanding .

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Overall effectiveness

This home provides a comprehensive package of therapeutic care guided by the individual needs of each young person. Young people's views about the quality of care they receive are unfailingly positive. There are very good relationships between staff and young people and this is core to the operation of this therapeutic community. Young people's views and opinions are central to day-to-day practice and are very regularly discussed. These contributions are greatly valued by the staff team and used to inform the daily routines, implement change and improve the quality of service provided.

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Overall effectiveness

Young people are very well safeguarded by consistent use of risk assessments, high staff supervision and a range of health and safety checks. The Registered Manager has a detailed development plan covering both medium- and longer-term service development. This includes improvement to, and expansion of, the current service in the future.

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Overall effectiveness

Some minor shortfalls were noted in the frequency of some health and safety checks, the clarity of monitoring reports and the frequency with which these reports are sent through to Ofsted. Additionally information relating to contacting the Children's Rights Director, Ofsted and Independent Reviewing Officers is missing from the young person's handbook.

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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 young person's guide includes information on how young people can find out their rights and how a child can contact their Independent Reviewing Officer, the Children's Rights Director, Ofsted if they wish to raise a concern with inspectors, and how to secure access to an independent advocate (NMS 13.5)  ensure that all staff's work is consistent with these Regulations and National Minimum Standards, the home's policies and procedures; this relates to frequency of emergency lighting tests and ensuring consultation with young people, parents and placing authorities is clearly recorded on Regulation 34 monitoring (NMS 21.3)  ensure copies of Regulation 34 reports are submitted to HMCI at 6 monthly intervals. (Children Act 1989 Guidance and Regulations, Volume 5: Children's Homes, paragraph 3.14)

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Outcomes for children and young people

Outcomes for children and young people are outstanding .

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Outcomes for children and young people

Young people are incredibly well supported to understand their backgrounds through constant engagement in highly individualised therapeutic programmes. These programmes help young people develop improved emotional maturity and resilience, an ability to self-regulate behaviour and a much more positive feeling of self-worth. This is further supported by the community meeting which involves young people organising their own activities for the day around the highly structured timetabled sessions which are already in place. Open, honest discussion, a pooling of ideas and the sharing out of tasks amongst the group helps develop team work, an ability to listen and a deeper understanding of themselves and their peers. These skills will help support young people in making decisions about their future lives.

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Outcomes for children and young people

Young people's health needs are exceptionally well met. The have good access to medical professionals as necessary and this is supported by staff who are qualified first aiders. Emotional health and well-being is the focus of the therapeutic input and is provided by a group of trained therapists. Additional external support can also be accessed if a specific need is identified.

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Outcomes for children and young people

Young people attend on site education and are achieving very well. Educational input is tailored to individual learning styles and includes a range of academic and vocational study. As a result young people achieve exam passes and work based qualifications including the First aid at work certificate, a food hygiene qualification and the CSCS basic health and safety award. These will be invaluable in the future for supporting job applications and helping young people achieve their potential. These outcomes show a huge step forward from where young people were when they first came to this home.

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Outcomes for children and young people

The community meetings provide the focus of the day and are held three times daily. Young people make a great contribution to the day-to-day running of the home through these meetings. This is by exploring feelings, discussing how their day has been, planning activities and agreeing additional tasks such as feeding the chickens. The full involvement of staff in these meetings ensures there is a complete sharing of information, immediate responses can be given and concrete plans made. These meetings also discuss more community based activities such as helping at the local bicycle refurbishment charity, planning the annual bonfire party and agreeing on roles for the pantomime production which has become something of a tradition. Boys also support the community by undertaking activities such as litter picking in the local park.

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Outcomes for children and young people

Young people are given excellent support to develop life skills for future independence and adult living. Young people are involved in preparing menus, cooking, budgeting and shopping. They take part in an annual off-site independence week which also involves preparing CVs and job applications and having a mock job interview videoed from which feedback is given. They are able to move into the 'independence bungalow' where staffing is minimal and they are fully expected to prepare their own food, do the laundry and keep the home tidy. These skills, allied to the qualifications they obtain, prepare young people extremely well for the transition to adult life.

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Quality of care

The quality of the care is outstanding .

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Quality of care

Young people and staff work very closely together in an exceptionally open and honest environment. This develops trust, an atmosphere of inclusion and engagement and ensures young people and their needs remain the primary focus of the community. One young person said 'staff treat us with respect, like young adults and it's really a respectful friendship rather than them and us.' This inclusive approach supports young people to develop good attachments to staff, which in turn supports the intensive nature of some of the therapeutic work being undertaken.

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Quality of care

Young people are very clear that this open approach allows for them to be involved in influencing the day-to-day running of the home as their voice is clearly heard. They are fully involved in taking responsibility for their behaviour and for overseeing the good conduct of the community. If sanctions are given young people are expected to reflect on the behaviour that led to this and on how their behaviour may have made others feel. Sanctions are agreed in community meetings and appropriately recorded. Young people request sanctions being lifted through explaining what they have done to resolve the situation and repair any damage done. Any 'victim' of poor behaviour is involved fully in these discussions. A senior member of staff said 'The boys do lots of reflective work so they can put themselves in each other's shoes. This is really empowering and is giving them an understanding of empathy for the first time.' In terms of emotional maturity and development this is

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Quality of care

a huge step forward for these young people.

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Quality of care

Individual care plans are based around the need for therapeutic input and for young people to address their harmful behaviours. Care plans are explicit and are compiled in conjunction with the community as each young person's therapeutic needs are different from another. Care provided is clearly in line with that laid out in these plans and young people all feel they are having their needs met in all areas of their lives.

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Quality of care

Young people's physical and emotional health needs are extremely well met. Young people attend routine health appointments and are given the responsibility for making these appointments themselves. They are also involved in work around health issues related to smoking and this helps them to take responsibility for their own health needs. Information regarding substance misuse helplines is on the noticeboard by the telephone, which further supports young people taking action in regard to their own health and wellbeing. This board also includes contact information for Ofsted, an independent advocate and other useful numbers. Contact details for Independent Reviewing Officers, Children's Rights Director and Ofsted are however, not available in the young person's handbook.

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Quality of care

Young people attend education as part of their therapeutic programme. As this is on site it is very well supported by staff and young people are attending and achieving very well. Staff are proactive and innovative in the way education is delivered. The balance of academic and vocational qualifications ensures that all young people will leave with some qualifications which will enhance their future life opportunities.

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Quality of care

A wide range of purposeful activities is offered to young people both on site and off. These include gardening, learning to drive, vehicle maintenance, games nights and quizzes on site. Off-site activities include swimming, bowling, theme parks, holidays and helping at a local charity which refurbishes bicycles to be sold back into the community. Besides the physical benefits of these activities the skills gained will again prove beneficial in the transition to adult life.

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Safeguarding children and young people

The service is outstanding at keeping children and young people safe and feeling safe. Young people's safety is of paramount importance in the home. Recruitment checks are very robust to ensure only suitably checked staff are able to work with young people. Visitors have their identity checked and are required to sign in and out and are chaperoned at all times. This ensures that the possibility of young people being at risk of harm from adults on the community's site is greatly reduced and young people are kept safe. Close circuit television covers external areas and this is monitored to prevent uninvited people coming on to the grounds.

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Safeguarding children and young people

Young people report that they feel very safe and that 'staff work extremely hard to keep us safe. This includes doing lots of therapeutic work, high staffing levels and escorting us when we go to off-site activities.' A designated member of staff is responsible for knowing the whereabouts of young people throughout the day and this has resulted in there being no instances of young people going missing since the last inspection. A detailed policy gives staff clear instruction on what they should do should this happen including how to reintegrate young people back into the community on their return. These procedures have been agreed with the local police and joint protocols are in place.

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Safeguarding children and young people

Positive behaviour is a bedrock of practice and is openly discussed and debated by the whole community several times a day. Negative behaviour is addressed and appropriate sanctions are imposed. Physical restraint is used only as a last resort and there have only been two instances of restraint since the last inspection. These have been clearly and accurately recorded and give an overview of the situation. Good discussions took place with young people following these incidents to ensure they understood why they had been held and to support them in identifying better ways to manage their behaviours. Allegations are rare but when they are made they are managed extremely well in line with policies and procedures.

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Safeguarding children and young people

The large main building and extensive grounds are regularly risk assessed and a range of health and safety checks are in place to further ensure young people are protected from accidents. However, some gaps in the frequency of fire alarm and emergency lighting tests could have resulted in young people being put at an increased level of risk. The home runs two large community events each year, a firework display and a pantomime. Young people take active roles in planning and running these events as appropriate to each individual. Risk assessments and staffing levels for these events are incredibly robust and the risk management systems very effective in safeguarding young people, staff and visitors.

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Leadership and management

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

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Leadership and management

The home has reshaped the leadership team since the time of the last full inspection and roles of senior staff are now very clear. The leadership is robust with assistant directors responsible for education, residential and clinical practice and this ensures each specification within the milieu team has a designated manager. Each of these staff teams dovetails well with the others to ensure a comprehensive service is provided. This consistent approach ensures young people have structure and routine in their day-to-day living.

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Leadership and management

There were no requirements or recommendations to address from the last inspection. However the service has continued to improve its provision and is looking to the future. Plans to link with a local regional college are at an advanced stage ahead of the coming requirement to provide education to the age of 18. An outreach service has been implemented to support young people in the initial months after they leave the service as they make the transition to adult life. Additionally there are plans to develop a 'hardship fund' to support former residents in setting up home and finding employment.

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Leadership and management

Regular monitoring is carried out by both the Registered Manager, or his nominee, and an external visitor. Young people are actively involved in consultation around the quality of service through three community meetings being held each day. The evidence of this in the monitoring reports is not as robust or clear as the Registered Manager would like. Additionally Regulation 34 monitoring reports have not been forwarded to Ofsted on a regular basis.

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Leadership and management

There are high staffing levels due to the potential high risk behaviours which can be exhibited by these young people. Staff receive regular supervision and an annual appraisal system is in place to monitor their progress towards developmental targets. Training is of a very high standard and all mandatory training is refreshed as required to ensure training remains current and relevant. This ensures staff work with young people in a highly consistent manner, vitally important in such a highly therapeutic environment.

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Leadership and management

The management has a clear understanding of the strengths and weaknesses of the provision. There is a highly detailed development plan in place to drive the service forward over the next year, five years and ten years in terms of staffing, strategic development and research. This far sighted approach is designed to ensure a high quality service to young people can be provided for the foreseeable future.

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Leadership and management

Young people's records are clear and provide a good insight into their life in the home. Recording is detailed and meticulous in detail. All appropriate notifications have been made to Ofsted and placing authorities as required. Due to the different behaviours some newer young people are exhibiting especially in terms of self-harm the home are tightening their processes on when notifications should be made. This transparency supports the on-going care and well-being of young people and ensures the home meets its responsibilities in all areas of reporting.

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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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