Children's Home run by Crystal Care Solutions Limited in Stoke-on-Trent

Unique reference number SC358638 Inspection date 17/12/2012 Inspector Katarina Djordjevic Type of inspection Interim Provision subtype Children's home

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Date of last inspection 13/06/2012 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

The children's home is part of an organisation operated by a private company. The home is registered to care for one young person aged eight to 17 years, with emotional and behavioural difficulties.

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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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Progress

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

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Progress

At the last inspection in June 2012 the overall quality rating for the service was judged as good; no requirements were made. The home has made inadequate progress since the last inspection. Although there are improvements in some areas, there are shortfalls in the management of young people’s behaviour; staffing arrangements; staff supervision and visits by the independent visitor. Three requirements and six recommendations for improvement have been made.

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Progress

Young people continue to receive individualised care and support which takes into account their age, gender, levels of abilities, sexual orientation, race, religion, culture and previous experiences. Young people are protected due to the effective implementation of the home’s safeguarding procedures. Young people have made good progress in some areas but not in others.

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Progress

Young people’s health has improved as they are more willing to attend health appointments. This is attributed to the tenacity of the staff team in helping young people recognise the benefits of being healthy and attending medical appointments. Staff provide information and explain different health conditions to young people. This helps them overcome any fears they may have about receiving treatment and become more emotionally resilient. Furthermore, staff are proactive in challenging barriers. They advocate on behalf of young people so they can continue to access the right medical services. For example, staff successfully negotiated for a young person to remain registered with a dental practice.

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Progress

Young people’s self-esteem and health slowly improves as a result of healthier eating and taking more exercise. As a result, they access and enjoy more activities in the community.

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Progress

The delay in young people moving to future placements has impacted negatively on their behaviours. There has been a recent increase in incidents of physical aggression and the use of physical intervention, which had previously not been used since May 2012. The police have been called to some incidents due to staff being unable to manage the behaviour of young people. A lack of consistent care, due to the large number of different staff working at the home, has contributed to the deterioration of young people’s behaviour. For instance, young people have been able to obtain keys and access the staff office. This has compromised confidentiality. Records of physical intervention and sanctions, alongside reports of incidents, demonstrate that staff have not always managed situations appropriately; their actions have, in some instances, escalated the situation. The poor management of young people’s behaviour has on occasion failed to protect young people and staff

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Progress

Young people have very good relationships with the core group of permanent staff. However, the home’s existing compliment of staff is currently insufficient to cover all shifts. As a result, a large number of different staff have been used to cover shifts. This hinders the home’s ability to provide a consistent standard of care that meets the needs of young people and also to drive forward improvement. Young people are not happy with the number of different staff working at the home.

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Progress

The Registered Manager is committed to improving the care provided to young people. She has improved the home’s development plan since the last inspection and introduced new systems such as de-briefing sessions. The home’s development plan is better tailored to the individual needs of the home and young people living there. Staff and young people now contribute to the content which helps them to have a say in the running of the home; deciding future plans for the home and helps them feel valued and listened to.

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Progress

The Registered Manager continues to monitor the quality of care in the home which includes carrying out monthly checks of records. This helps to ensure young people receive care based on their needs and identify any shortfalls. Ofsted has not received a report regarding the internal monitoring of the quality of care as required. This prevents Ofsted from monitoring the quality of care provided in the home.

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Progress

Since the last inspection, as part of monitoring the quality of care, the Registered Manager has introduced debriefing sessions for staff who have been involved in incidents of physical intervention. This is a useful tool which further helps the Registered Manager monitor staff performance and identifies any training needs. However, debrief sessions do not routinely take place with all staff involved; and sessions are not sufficiently robust in identifying and recognising shortfalls in practices. Consequently, this prevents adequate identification of staff training needs and prevents informing future safe behaviour management practices.

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Progress

The routine monitoring completed by the registered provider, in line with Regulation 33 visits by a representative of the organisation, has not been robust. The Registered Manager has identified inaccuracies in the findings of the reports produced and has taken action to have these rectified. For example, the report for November 2012 states the gas installation had not been serviced. However, a certificate shows that servicing took place in September 2012. This makes it difficult to accurately assess if health and safety requirements are being met. Furthermore, identified shortfalls, are not always promptly addressed resulting in some actions being constantly repeated. For example, the paving slabs in the rear garden are uneven and pose a hazard to young people and staff. Furthermore, staff do not receive regular supervision in line with the home’s policy. This does not ensure that young people are receiving care in

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Progress

line with their individual needs and that any shortfalls in staff practice are consistently addressed.

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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 all parts of the home to which children have access are so far as reasonable practicable free from hazards to their health or safety. With specific reference to ensuring children are not able to access keys to the staff office and other areas which may pose a risk; and to repairing or replacing the paving slabs in the rear garden (Regulation 23 (a)) 31/01/2013

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Reg. Requirement Due date

17B (2001) prepare and implement effectively a written behaviour management policy which sets out the means whereby appropriate behaviour is to be promoted in the home. With specific reference to ensuring staff are competent in effectively and consistently implementing the home’s behaviour management policy (Regulation 17B (1)(b)) 31/01/2013

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Reg. Requirement Due date

(2001) ensure that the employment of any persons on a temporary basis at the children’s home will not prevent children from receiving such continuity of care as is reasonable to meet their needs. With specific reference to providing a consistent core group of staff to work with children. (Regulation 25 (2)) 31/01/2013

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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 all children and staff are given an opportunity to discuss incidents of restraint they have been involved in, witnessed or been affected by, with a relevant adult (NMS 3.17)  review regularly incidents of challenging behaviour, examine trends or issues emerging from this, to enable staff to reflect and learn to inform future practice (NMS 3.21)  ensure all staff receive regular supervision in line with the home’s policy; and that records clearly indicate when supervision has taken place, and if not, give the reason why (NMS 19.4)  ensure that the registered provider Regulation 33 visits are effective in identifying any shortfalls and that they are accurate in their findings (NMS 21.7)  take action to address any issues of concern that are identified or which are raised in the registered provider Regulation 33 reports (NMS 21.9)  complete at six monthly intervals and send a copy of the Regulation 34

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Recommendations

monitoring report within twenty eight days of completion to Ofsted. (Children Act 1989 Guidance and Regulations Volume 5: Children’s Homes paragraph 3.14)

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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.

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