Children's Home run by Amicus Residential Care Ltd in Reading

Unique reference number SC059221 Inspection date 06/12/2012 Inspector Maureen Hamer Type of inspection Full Provision subtype Children's home

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Date of last inspection 27/03/2012 Website: www.ofsted.gov.uk

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Brief description of the service

The home is privately run and provides emergency as well as long-term placements for up to three young people with emotional and/or behavioural difficulties.

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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 good .

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Overall effectiveness

This home provides young people with a stable environment. A particular strength of the service is that young people feel listened to and respected by the caring staff group. There is a significant reduction in young people's risk taking behaviours. Staff are good advocates for young people promoting their access to school and ensuring that they are kept safe.

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Overall effectiveness

Staff communicate well and help young people to manage their emotions; this has contributed to reducing episodes of challenging behaviour. There is minimal use of physical restraint and the recording and support after such incidents are usually good but the staff debrief is not well recorded in the restraint log. The good communication between staff ensures that young people are cared for in a consistent manner. However care and behaviour plans do not include all relevant information and there is sometimes insufficient detail about young people's progress.

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Overall effectiveness

Staff are administering controlled medication but are not trained about the administration, storage and auditing of such medication. This has not impacted negatively on young people.

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Overall effectiveness

Quality assurance monitoring has greatly improved and the manager is aware of strengths and weaknesses in the home. Care plans, risk assessments and behaviour plans have improved but do not consistently show targets set or progress achieved. The views of young people, parents and placing authorities are sought and used to inform priorities but this is not evident in the reports that are submitted to Ofsted.

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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) promote and make provision for the welfare of children in particular comprehensive care, behaviour and risk plans (Regulation11 (1)(a)) 28/02/2013

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Reg. Requirement Due date

(2001) ensure that all persons employed by him receive appropriate training particularly relating to the administration of medication (Regulation 27 (4)(a)) 28/02/2013

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Reg. Requirement Due date

(2001) include within schedule 6 monitoring reports the consultation provided for to children accommodated in the home, their parents and placing authorities. (Regulation 34 (3)) 28/02/2013

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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 that staff involved in any incident of restraint have the opportunity to talk about this with a manager or supervisor in the home (NMS 3.17)  ensure staff follow best practice in administering medication, in particular controlled drugs. (NMS 6.14)

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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

Young people state that they enjoy living in this home. They say that staff listen to what they say and this makes them feel respected and helps them to build constructive relationships with staff.

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Outcomes for children and young people

All young people are relatively new to the home. Some young people have specific issues such as mild learning difficulties and autism that contribute to communication problems. Young people greatly appreciate the time that staff take to ensure that there is a good understanding about how they feel and helping them to express themselves. This helps them to reflect on past experiences and how they contribute to their challenging and risk taking behaviours. Young people are developing the ability to empathise with how others are affected by their behaviours. As a result young people are beginning to build positive relationships with significant people in their lives and this is promoting their self-esteem. Access to local health services is established to ensure that young people have their health needs met. Preventative health services such as sexual health clinics are used to enable young people to gain appropriate help and advice to promote their well-

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Outcomes for children and young people

being. Some young people smoke and they are made aware of the harm that this habit does to them; plans to promote smoke reduction programmes are in place.

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Outcomes for children and young people

All young people have been successful in reducing risk taking behaviours such as alcohol and illegal drug taking. The changes in their risk taking behaviours have had a significant impact on their emotional well-being and have also resulted in a reduction in challenging behaviour.

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Outcomes for children and young people

Prior to admission to the home, school attendance and achievement has been problematic. Young people now have school placements and their educational needs are being assessed and addressed. Some young people have had on-going issues at school about bullying and staff in the home are strong advocates for young people to have such issues resolved. As a result young people are willing to return to school so that they can maximise their educational opportunities.

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Outcomes for children and young people

Young people are engaged in activities outside of the home to promote a range of skills. Some young people are accessing work experience such as working in a charity shop. In addition young people have very good engagement in the looked after children council’s and this has included the opportunity to participate in interviewing council staff such as the Children’s Services Director. This provides young people with good opportunities to develop interview and team skills that promote self-confidence and are helpful as part of their curriculum vitae.

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Outcomes for children and young people

Independence skills are promoted. Young people are responsible for keeping their rooms tidy and they contribute to menu planning, food preparation and cooking. Budget management is encouraged so that as they move into independent living they have developed some living skills to promote a successful transition. As a result of positive relationship building in this home young people build self- reflection skills so they are more aware of how their behaviour affects others. For some young people, plans are made for their permanent return to their parent’s home. As a result there are successful home visits, and parents feel better able to cope.

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Quality of care

Staff are highly skilled at effectively communicating with young people. This enables young people to quickly develop good relationships with staff in the home.

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Quality of care

Key worker sessions take place on a regular basis and focus on engaging young people in their care. In addition staff are good at gaining young people’s views about the reports that contribute to their regular statutory reviews. This helps young people to have a sense of control over their lives. An independent reviewing officer stated that they are warmly invited into the home to talk to young people in preparation for reviews as well as on an ad hoc basis.

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Quality of care

Young people say that staff give them freedom and responsibility. This helps young people to consider their options and reflect on consequences of their choices; this is empowering to young people.

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Quality of care

Staff work with young people to help them to personalise their bedrooms that are their private space. Regular house meetings enable good discussion between young people and staff about a range of issues such as menu setting and behaviour in the home. This gives young people a sense of ownership in the home and promotes working with others to create a homely environment.

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Quality of care

There is effective support in the home to help young people to manage disappointment. Staff ensure that young people who have literacy issues have the children’s guide explained to them so that they know what to expect including how to raise concerns and make a complaint.

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Quality of care

Staff are sensitive to young people’s emotions and of early signs of anxiety and frustration. Staff act to avoid triggers and to de-escalate negative behaviours, for example by providing space for young people to be on their own and to calm down. In addition staff are good at being consistent with applying incentives and consequences. Since the last full inspection there have been two episodes of physical restraint and no incidents involving the current group of young people. However while staff have very good communication about young people’s behaviours their care and behaviour plans are not always comprehensive and their progress is not always well monitored.

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Quality of care

Staff communicate well about young people’s behaviour and act effectively to promote their well-being. However behaviour and risk assessments do not contain all relevant information. Consequently young people’s progress is not always comprehensive.

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Quality of care

Some young people have problems accessing educational provisions. Staff act as good advocates for young people to enable access to appropriate education. In addition when issues arise such as bullying, staff act promptly enabling young people to attend school. Partner organisations state that the advocacy that the home provides is a particular strength of the service.

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Quality of care

Staff support young people who get homework. One young person said ‘I can’t read: staff are good ,they help me to understand what I need to do and help me to get homework done.’ This promotes young people’s educational attainment.

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Quality of care

Young people enjoy going out with staff to a range of leisure activities such as the cinema and playing pool where they get an opportunity to socialise and enjoy evening activities. These diversionary activities also contribute to reducing young people’s anti-social behaviour. Staff are currently administering controlled drugs. The home’s policy and staff training is not up-to-date, and does not follow guidance on the storage and recording of such medication. This hinders effective monitoring.

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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 state that they feel very safe and secure in this caring environment. Staff promote a positive culture within the home and any signs of intimidation are effectively managed.

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Safeguarding children and young people

The home has updated its ‘missing from care’ risk assessments and protocols so that in the event that young people go missing information is readily available to communicate to the police. Prior to living in this home some young people have had a history of going missing but this behaviour has stopped, enhancing young people’s welfare.

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Safeguarding children and young people

Occasionally young people are still absent without authority and on such occasions have maintained communication through the use of mobile phones. On return to the home staff talk to young people about the reasons for going absent and encourage young people to act in a responsible manner and to negotiate their absence with staff.

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Safeguarding children and young people

As a result of providing consistent and positive care, the home has been successful in reducing other areas of risk taking behaviours such as anti-social behaviour.

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Safeguarding children and young people

Physical restraints are rarely used in this home. All incidents are recorded and young people are debriefed and provided with an opportunity to express their views about any such incidents. Any incidents are discussed at team meetings but debriefs to staff are not recorded in the physical restraint log. This impacts on the manager’s ability to monitor and evaluate such events. This shortfall has not impacted on young people.

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Safeguarding children and young people

There is good vetting of staff and references are verified to ensure that young people are cared for by appropriately trained staff.

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Safeguarding children and young people

Staff are aware of the referral processes when an allegation or disclosure takes place. The home is active in working with partners to ensure that investigations are carried out robustly, ensuring that young people are kept safe.

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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

This home is effectively managed. The culture of the home is to provide a homely environment and to help young people to do well. The manager strives to motivate the staff team to promote continual improvement. The home’s Statement of Purpose reflects the aims and objectives of the home and enables parents and placing authorities to know what to expect from the home.

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Leadership and management

All recommendations from the last inspection have been met. The effectiveness of sanctions is monitored to demonstrate that they are having a positive impact on young people’s behaviours. Safe self-administration of medication is risk assessed to promote young people’s independence. The home ensures that access to services such as mental health services is provided to promote young people’s welfare. Young people’s records are kept secure to respect young people’s rights to confidentiality.

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Leadership and management

The manager has worked with her whole staff team to review the standard of care provided to young people and to assess how well young people are kept. In addition to that audit the manager completes regular quality assurance monitoring. As a result the manager is aware of the strengths and weaknesses of the service and has put in place a programme of improvement. This work has informed the home’s development plan and shows capacity to improve.

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Leadership and management

The manager listens to the views of young people, their parents and local authorities and utilises feedback to inform service delivery. However this is not evidenced in the regulation 34 reports submitted to Ofsted.

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Leadership and management

The one complaint since the last inspection has been responded to effectively and fairly and is well documented so that lessons can be learnt and future complaints can be avoided.

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Leadership and management

The home has had some redecoration and improvements. Young people feel that the home is comfortable. They say there is sufficient shared space to enjoy each other’s company while also benefiting from their own private space.

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Leadership and management

Staff feel very well supported. Team meetings and supervision are undertaken on a regular basis and is young people focused. When issues related to safeguarding and behaviour management occur they are fully discussed at these meetings so that lessons can be learnt and actions reviewed.

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Leadership and management

Significant events that relate to the protection of young people are reported to relevant partners to ensure that young people are kept safe.

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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 and the evaluation schedule for children's homes.

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