Children's Home run by Institute of Integrated Systemic Therapy in Kent

Unique reference number SC454294 Inspection date 16/04/2013 Inspector Janet Hunnam Type of inspection Full Provision subtype Children's home

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Date of last inspection 02/11/2012 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 home is registered to provide care and accommodation for four young people with emotional and/or behavioural difficulties. It is operated by a charitable organisation.

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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

Young people receive high standards of care within a therapeutic environment, which reflects their individual needs so that they make significant progress in all aspects of their lives. An enthusiastic, cohesive and dedicated staff team, led by experienced and knowledgeable senior managers, provide intense support for young people. Young people are at the centre of all care planning, with staff continuously mindful of delivering strategies which promote improved outcomes for young people.

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Overall effectiveness

Consistent and constructive relationships between staff and young people are the foundation of support for young people within a safe and stable environment. Young people are positive about living at the home giving it a score of 10 out of 10 with no areas where it could improve. A young person stated ‘the best thing about the home is the staff.’

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Overall effectiveness

Excellent safeguarding practice is in place at the home. Close supervision and monitoring of young people, on-going assessment of risk and in-depth understanding of young people’s specific vulnerabilities contribute to their safety and well-being.

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Overall effectiveness

Staff receive comprehensive training and extensive support and supervision ensuring they have the skills to promote young people’s progress. However, staff have not completed the Children’s Workforce Development Council’s induction programme within six months of commencing work at the home.

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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 new staff undertake the Children's Workforce Development Council's induction standards, commencing within seven working days of starting their employment and being completed within six months. (NMS 18.3)

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Outcomes for children and young people

Social workers report that young people are making significant progress at the home. They commented that the home is ‘fantastic, absolutely brilliant’. They stated that a young person has developed, made excellent progress, settled at the home really well and has made good attachments quickly with their key worker. A family member stated they have seen ‘a vast improvement’ in the young person’s behaviour. Highly individualised support helps young people develop trusting relationships with staff, enabling them to increase their self-esteem so they feel valued and respected.

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Outcomes for children and young people

Young people benefit from close attention to their physical health needs. Staff support them to lead healthy lifestyles through healthy eating patterns and enjoyable exercise activities. Emotionally and psychologically, young people receive intense therapeutic support, through individual and group work, to manage their on-going needs and risks in terms of the trauma they have experienced. Over time, young people make excellent progress.

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Outcomes for children and young people

Educationally, young people are making good progress. They have a positive attitude to their learning, enjoy going to school and have excellent attendance. Young people make a positive contribution within the home. Staff promote and encourage open communication about all aspects of living together. Young people thus feel that staff listen and respond to them and their opinions matter.

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Outcomes for children and young people

Young people benefit from the high priority the home affords to appropriate contact with their families. The home’s family support officer is proactive in establishing positive contact for young people. A social worker commented that this input has been extremely constructive in enabling a young person to re-establish contact with their family.

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Outcomes for children and young people

Social workers report that communication with the home is ‘excellent’ with a real sense of ‘working together’ for the benefit of the young person. Monthly reports provide detailed progress accounts on all aspects of a young person’s life at the home.

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Quality of care

The quality of the care is good . Within a therapeutic environment, young people with complex needs develop positive relationships with others. Highly effective and well-trained staff, work within a framework of integrated systemic therapy, providing opportunities for young people to make healthy attachments, process their feelings and relate to others. Staff are reflective, thoughtful and responsive to young people giving them the confidence to trust staff, develop constructive relationships and react positively to the support given to them. Staff value young people and their relationships with them. Consequently, as their capacity to relate to others increases, young people’s self- esteem and view of themselves improves and allows them to make progress in all aspects of their lives. Staff commented that their role is not about just caring for young people but understanding them and helping them to move forward positively.

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Quality of care

Young people are encouraged to express their views, thoughts and feelings in relation to all aspects of their lives at the home. Young people say they can raise concerns easily and staff respond. They are involved in daily matters such as menu planning and choosing activities and are encouraged to make suggestions to improve their everyday experience at the home. They are actively involved in their care plan and in the setting of personal targets to help them address specific issues. Regular reviews of their progress enable young people to recognise their achievements and identify areas where they require additional support.

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Quality of care

A comprehensive programme for care planning ensures young people have their specific needs met. Care plans are written from the young person’s point of view with detailed assessment of their needs and the support they require. Social workers report that the home excels in meeting young people’s individual needs enabling young people to make ‘brilliant progress’. A strength of the home is the staffs’ recognition and assessment of young people’s emotional and psychological needs along with an integrated programme of therapeutic care, treatment and education to address young people’s difficulties. Individual psychotherapy sessions are available for young people. Staff receive valuable training to work within the home’s therapeutic model. They are effectively supported through frequent individual and group supervision sessions with senior practitioners and consultant child and adolescent psychotherapists. Within this framework, young people develop and make

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Quality of care

Education is an integral part of the therapeutic framework at the home. Specialist teaching staff provide on-site education for young people in a therapeutic and holistic way. Residential staff work closely with teaching staff to support young people’s education and promote their attendance and achievement. Young people benefit from this liaison and staffs’ awareness of young people’s emotional state. Consequently, they have improved chances of achieving their educational potential and improved future adult opportunities.

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Quality of care

Young people are encouraged to pursue a variety of activities individually and as a group. They make full use of the spacious grounds for outdoor activities. They also use local community amenities for activities such swimming, climbing and the cinema. Young people choose individual activities and staff fully support them in following their particular interests and abilities. Examples of such activities are horse riding and growing plants. Young people also integrate into local community group activities such as Scouts and Guides enabling them to benefit from wider social interaction with their peers, develop their social skills and increase their self-esteem.

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Quality of care

Young people live in a spacious home, which has recently been refurbished to an extremely high standard providing a bright and welcoming family atmosphere. Furnishings and décor are of high quality. Each young person has personalised their bedroom reflecting their own personality and interests and giving them a sense of identity and belonging. The home is located in a rural setting but near local amenities.

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Safeguarding children and young people

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

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Safeguarding children and young people

A culture of safety protects young people and their welfare is central to practice at the home. Staff are competent and appropriately trained in child protection and safeguarding procedures. Young people have no concerns regarding their safety living at the home. Social workers and family members confirm young people’s safety at the home. Staff understand the specific vulnerabilities of young people and appropriate measures are in place to protect them. High staff ratios allow close supervision of young people but they are also encouraged to have privacy and given opportunities to develop independence skills.

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Safeguarding children and young people

Detailed assessments identify risk taking behaviour and outline appropriate measures to protect young people and minimise potential harm. Staff monitor and review these risk assessments to assess the effectiveness of risk reduction strategies. Individual behaviour management plans identify young people’s specific areas of difficulty, potential triggers of challenging behaviour and preferred supportive and handling strategies.

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Safeguarding children and young people

Close monitoring ensures staff know where young people are at any time and there have not been any incidents of young people going missing. Clear procedures are in place in line with agreed local protocols to protect young people if they leave the home without permission.

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Safeguarding children and young people

The establishment of positive relationships between young people and staff, within clearly defined safe and consistent boundaries, underpins the promotion of positive behaviour within the home. Staff support young people to understand the effect of their behaviour on others and encourage them to behave and relate to others in ways that impact beneficially. Sanctions are not a primary response to inappropriate behaviour and no sanctions have been imposed in recent months. Within the home’s therapeutic framework, staff work to help each young person share responsibility for group and individual well-being. In the process of young people developing trust and cooperation, staff use an approach of understanding and acknowledgement of young people’s histories and consequent trauma to respond to negative behaviour. Physical intervention is also rarely used and only as a last resort. Staff have training in the

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Safeguarding children and young people

use of restraint and any incidents are clearly and comprehensively recorded, including the views of the young person. Bullying is not an issue at the home though staff have an awareness of any potential occurrence and address any controlling behaviour promptly. Within this ethos of behaviour management, young people are taking more control of their feelings and their response to their emotions. Consequently their behaviour is improving.

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Safeguarding children and young people

The home has a very clear and robust recruitment process, which ensures that all checks for prospective employees are completed before they commence working with young people. This ensures that only adults with acceptable personal and employment histories support vulnerable young people.

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Safeguarding children and young people

The management of health and safety in the home is rigorous and helps protect young people and staff from the risk of harm and injury. All staff are trained as fire wardens and maintenance staff conduct regular checks on fire safety. Detailed and comprehensive risk assessments relating to the environment identify potential hazards and risk-reduction measures.

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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

A highly experienced Registered Manager, who has extensive senior management experience and qualifications in therapeutic residential care, manages the home effectively. He manages two homes on the same site. He is supported by experienced and competent senior managers and a committed and dedicated staff team who place the well-being and the needs of young people at the centre of their practice.

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Leadership and management

The home opened in November 2012 and no concerns or complaints have arisen. Managers have clear plans in place to develop the service, maintain high standards of care and support young people to improve their outcomes in all areas of their lives. Monitoring of care standards within the home is rigorous and robust. Monthly monitoring visits include consultation with staff and young people and the report outlines recommendations for improvement. Managers monitor all aspects of the home monthly to identify patterns and trends and to detect and rectify any areas of weakness enabling young people to benefit from high standards of care.

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Leadership and management

A new staff team has undertaken a comprehensive training programme ensuring they have the skills and knowledge to support young people in their care effectively. The home provides on-going intense and in-depth support and supervision for staff within the therapeutic framework, ensuring they have a thorough understanding of their therapeutic role in working with young people. Individual supervision is provided fortnightly. Weekly staff meetings, weekly group supervision meetings, case discussions and staff dynamic meetings supported by a psychotherapist provide staff with additional support. This also facilitates their understanding of young people as individuals and as a group. This strong support structure for staff has allowed the new staff team to develop their skills quickly and coherently and establish an ethos and therapeutic expertise to meet the needs of young people suffering profound emotional and psychological trauma. Staff report they are very well supported which

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Leadership and management

enables them to provide high quality support for young people.

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Leadership and management

Staff have commenced the Children’s Workforce Development Council’s induction programme but have not completed it within six months of commencing work at the home. A social worker commented positively in relation to the training and expertise of staff and how well they recognise and assess young people’s emotional needs.

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Leadership and management

Report writing and record keeping is a strength of the home. Staff maintain accurate records, which ensure the needs of each young person, are known, reviewed and planned for. Documentation provides an accurate and up-to-date picture of young people’s life at the home and the impact the care they receive is having on them.

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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 the inspection of children's homes.

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