Children's Home run by Compass Children’s Homes Kent Limited in Kent

Unique reference number SC425071 Inspection date 10/05/2013 Inspector David Putnam Type of inspection Full Provision subtype Children's home

p.1

Date of last inspection 07/01/2013 Website: www.ofsted.gov.uk

p.1

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.

p.2

Brief description of the service

This privately run children's home is registered to provide care and accommodation for up to six children and young people with emotional and behavioural difficulties. Education is available on site. Therapy is available to young people if required.

p.3

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

p.3

Overall effectiveness

The overall effectiveness is judged to be inadequate .

p.3

Overall effectiveness

Some young people are able to identify positive changes as a result of living in this home. While some young people are satisfied with the quality of care they receive, others express their dissatisfaction.

p.3

Overall effectiveness

Care planning is personalised, but implemented by a relatively new and inexperienced staff team. Young people have to cope with changes in managers and staff which affect their ability to form and maintain relationships over time.

p.3

Overall effectiveness

The health and safety of young people is affected by a lack of attention to detail. Relationships between some young people are difficult. Staff maintain the safety of young people by keeping them apart, resulting in a limited sense of community or togetherness. Damage caused results in a poor environment that lacks a homely feel.

p.3

Overall effectiveness

Changes in management arrangements within the home result in a lack of monitoring and consequently a poor understanding of the significant need for improvement.

p.3

Overall effectiveness

While outcomes for young people are adequate, the home does not provide adequate quality of care or promote the safety and welfare of young people, and the leadership and management of the service is inadequate. There are numerous shortfalls in all judgement areas. Extensive statutory requirements and recommendations are made to promote urgent improvement.

p.3

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.

p.4

Reg. Requirement Due date

(2001) promote and make proper provision for the welfare of children accommodated in the children's home; in particular by ensuring that regular and full recording is completed in respect of each child which informs processes for identifying and reducing potential risks and hazards (Regulation 11 (1)(a)) * 14/06/2013

p.4

Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline, a written record is made in a volume kept for the purpose of which shall include all matters listed in these regulations (Regulation 17B (3) and (4)) * 14/06/2013

p.4

Reg. Requirement Due date

(2001) promote the physical health needs of children accommodated in the children's home, in particular through the provision of adequate first aid equipment (Regulation 20 (1)) 05/07/2013

p.4

Reg. Requirement Due date

(2001) ensure that at all times, at least one person on duty at the children's home has a suitable first aid qualification (Regulation 20 (2)(e)) 05/07/2013

p.4

Reg. Requirement Due date

(2001) make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home (Regulation 21 (1)) * 14/06/2013

p.4

Reg. Requirement Due date

(2001) ensure that electronic or mechanical monitoring devices for the surveillance of children are not used except for the purpose of safeguarding and promoting the welfare of the child concerned, or other children accommodated in the children's home, and that all conditions set out in this regulation are met (Regulation 22 (1) (a) to (d)) 05/07/2013

p.4

Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate supervision, in particular, that the frequency of supervision meets with the policy set out by the children's home (Regulation 27 (4)(a)) 05/07/2013

p.4

Reg. Requirement Due date

(2001) ensure that all parts of the children's home used by children are kept clean and are reasonably decorated and maintained (Regulation 31 (2)) * 14/06/2013

p.4

Reg. Requirement Due date

(2001) ensure, by means of fire drills and practices at suitable intervals, that the persons working at the home are aware of the procedure to be followed in case of fire (Regulation 32 (1)(e)) 05/07/2013

p.4

Reg. Requirement Due date

(2001) ensure visits by the registered provider under this regulation shall take place at least once a month, prepare a written report and supply a copy of the report required to the HMCI (Regulation 33 (3),(4)(c) and (5)(a)) 05/07/2013 (2001) establish and maintain a system for monitoring the matters set out in Schedule 6 at appropriate intervals and improving the quality of care provided in the children's home. Supply to the HMCI a report in respect of any review conducted. The established system shall provide for consultation with children accommodated in the home, their parents and placing authorities. (Regulation 34) 05/07/2013

p.4

Reg. Requirement Due date

*These requirements are subject to a compliance notice

p.5

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.5

Recommendations

 ensure children understand how their views have been taken into account, and where significant wishes or concerns are not acted upon, they are helped to understand why (NMS 1.2)  ensure that the children's home has a record of the recruitment and vetting checks which have been carried out on those working (including as volunteers) for the children's home which includes all matters set out in this standard. (NMS 16.3)  ensure that where practicable, children are involved in the recruitment of staff in the home (NMS 16.8)  make every effort to achieve continuity of staffing so that children's attachments are not overly disrupted (NMS 17.8)  ensure that all staff engaged from the commencement of the national minimum standards are to hold the level 3 Children and Young People's Workforce Diploma which must include mandatory social care units; or be working towards the diploma within six months of confirmation of employment (NMS 18.5)

p.5

Recommendations

 ensure that all staff have their performance individually and formally appraised at least annually and this appraisal takes into account the views of children the service is providing for (NMS 19.6)  monitor, in line with regulations, all records kept by the home to ensure compliance with the home's policies, to identify any concerns about specific incidents and to identify patterns and trends: including consistency of behaviour management (NMS 21.2)  ensure staff understand the nature of records maintained; in particular ensure that staff follow the home's policy for reading and signing records. (NMS 22.1)

p.5

Outcomes for children and young people

Outcomes for young people are adequate . Young people make adequate progress in viewing themselves positively. Young people say, ‘It’s good, I’ve got a routine now.’ They acknowledge that as a result they now attend school every day, whereas previously they were excluded from school. External education providers and staff within the on-site school describe children’s progress as good. Over time, young people manage their behaviour better within school, enabling to make the most of learning opportunities.

p.5

Outcomes for children and young people

Counselling or therapy is available to all young people to help them understand their early life experiences and improve their emotional and psychological health. Irrespective of whether young people take up the option of therapy, therapists also meet with staff to help them explore and understand the reasons behind behaviours exhibited by young people. The physical health needs of young people are met through registration with local health professionals.

p.6

Outcomes for children and young people

Placing authorities and staff agree any plans to ensure that young people enjoy positive experiences of visits to their families. This guarantees that young people stay in touch with people who are important to them.

p.6

Outcomes for children and young people

Young people build self-confidence in their ability to manage out in the community, without the constant supervision of staff. Staff take the individual needs of each young person into account, ensuring that independence is progressed at a pace that keeps young people feeling safe. Young people take part in activities that link them to the wider community and allow them to make friends who share similar hobbies and interests.

p.6

Quality of care

While some young people indicate that they are satisfied with the quality of care provided, others say that they hate living in the home and want to move. Some young people express clearly that they do not get on with everyone living in the home and this causes them difficulties. One said, 'When I talk to staff they say I'm lying.' This results in them feeling angry, frustrated and not heard.

p.6

Quality of care

Violent incidents have occurred between young people. Staff often manage such difficulties by simply keeping young people apart. As a result, there is a limited sense of community or cohesion within the home. Young people say they never do things together as a group. Activities, such as watching television or playing a game together, are not undertaken. This is emphasised by the fact that the living room contains insufficient furniture to allow young people and staff to all sit together.

p.6

Quality of care

Several recent changes to the staff group result in a lack of consistency and continuity for young people. Despite the opportunity to involve young people in the selection of new staff, this has not happened. Consequently, young people do not see how their views, wishes and feelings influence the running of the home. Residents’ meetings limit individual contributions to menu choices or activities undertaken individually. However, staff and in-house therapists have recently introduced a more therapeutic approach to house meetings. Only one such meeting had been held so far. Initially not all young people were willing to engage fully with this process.

p.6

Quality of care

Standards of cleaning around the home are not adequate. Staff know bathrooms are dirty, but do not clean them. There are poor standards of food storage and general hygiene in the kitchen that present a risk to children.

p.7

Quality of care

Practices for storage, recording and administration of medicines are not safe. Records are inconsistent, difficult to follow and reflect inaccurate stock of controlled medication. A controlled medication record book is used to record the administration of all prescribed drugs. Staff do not consult with the dispensing pharmacist when there are discrepancies in medication delivered and change records without seeking their advice to confirm quantities. In addition, stock of homely remedies does not match the records held for individual young people. Such shortfalls pose a significant potential risk to young people.

p.7

Quality of care

Staff acknowledge that the environment does not feel homely. Levels of damage around the home have increased and the home looks scruffy and unkempt. Where possible, repairs are carried out promptly by a contracted maintenance person. However, some tasks highlighted as costly remain unfinished. For example, one of the oven doors in the kitchen has been missing for several months; a glass shower cubicle door has had to be replaced with a temporary curtain and a bracket for a large screen television remains on the wall several weeks after the television was broken. Added to this, staff store unused equipment, such as a photocopier, two printers and replacement doors in the young people’s games room. As a result, young people do not use the room frequently. Currently, two empty bedrooms cannot be used because of damage to curtain poles, bed frames and other basic furniture.

p.7

Quality of care

Young people have built reasonable relationships with a relatively new and inexperienced staff group. Care staff communicate well with education staff at the on-site school and liaise effectively with other schools attended by young people. This helps to support the educational progress of young people. Staff provide adequate reports for placing authorities to inform meetings to review individual care plans for young people. Young people say that they are able to contribute to these meetings and express their views and ambitions for the future.

p.7

Safeguarding children and young people

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

p.7

Safeguarding children and young people

Some young people clearly state that they feel safe within the home. At the same time others express dislike for each other that at times leads to physical violence between them. Staff take action to address such incidents, in particular when they are perceived as bullying. However, responses are not made consistently or in a way that helps young people to manage their behaviour effectively. While reports of such incidents are recorded, they are not monitored or reviewed effectively by managers. This means that lessons are not learnt, consistency is not maintained and sanctions imposed by staff sometimes fail to link logically to the behaviours of individual young people.

p.7

Safeguarding children and young people

Staff get to know young people reasonably well. Staff say that communication between them is positive and that they support each other. Young people are able to talk to individual staff openly. Other leaders and managers from the organisation provide another outlet for young people to express any concerns. Young people rarely go missing from the home, although positive links have been formed with local police to ensure a prompt response when this does happen.

p.8

Safeguarding children and young people

Young people say that the frequency of incidents when they are restrained is reducing over time. For some this reflected a reduced number over a significant period. Others highlighted that following periods of frequent restraints they are able to go for periods of more than a week without being restrained. This suggests that young people are able to manage and improve their behaviour. However, records indicate that there is still an average of two restraints each week.

p.8

Safeguarding children and young people

While staff record these restraints, the standard of recording does not meet the expected standard. Records do not consistently include all required elements. In particular, they consistently fail to show that the young person or the member of staff has been spoken to about the restraint. As a result, they are unable to express their views and learn from the experience. Some records are made on sheets of paper which are then inserted into the bound log. This provides the opportunity for records to be lost, amended or removed. The majority of records are not reviewed or signed off by a manager. This means that there is no effective monitoring of the incidence of restraints.

p.8

Safeguarding children and young people

Records state that only four members of staff have a valid first aid qualification. Consequently, there are times when no qualified first aider is available. Furthermore, there are no effective checks of the contents of first aid kits, so these are not adequately stocked. As a result, young people, staff or visitors would not be able to receive prompt or appropriate first aid treatment should the need arise.

p.8

Safeguarding children and young people

Risk assessments relating to individual young people are not regularly reviewed to ensure they are kept up to date. Some current documents are not stored on working files. This means that staff are unaware how risks and hazards should be minimised or informed of any changes in approach.

p.8

Safeguarding children and young people

Checks of gas and electrical services to the home are carried out within expected timescales. Routine health and safety checks and fire risk assessments also help to safeguard the welfare of young people. Fire drills are carried out regularly, especially following the arrival of new young people. This helps to ensure that young people know what to do in the case of an emergency. However, practice during drills does not include a roll call of any kind, so staff are unable to evidence how they would know if everyone had cleared the building in the case of an emergency. All children’s bedrooms are fitted with locks to keep young people’s belongings safe. In addition sensors are fitted to each bedroom door. These are switched on at night and signal an alarm to staff should young people open their bedroom door. Managers state that this is to safeguard young people. However, they were unable to provide evidence that the use of these monitoring devices is included in individual

p.8

Safeguarding children and young people

placement plans or agreed by young people or placing authorities.

p.9

Safeguarding children and young people

One young person has fitted locks to the outside of the bedroom door; staff are aware of the situation. However, there is a risk of the young person becoming locked in, either by accident or as the result of a prank. Staff did not have keys for all the locks and failed to identify potential concerns about this; they took immediate action to remove the locks when potential risks were pointed out.

p.9

Leadership and management

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

p.9

Leadership and management

The post of Registered Manager has been vacant since 8 March 2013. Since that time, two people have held the role of acting manager. The first moved to manage the other home in the group. The current acting manager took up the role three weeks ago and reported the intention to submit an application to register with Ofsted shortly.

p.9

Leadership and management

Ofsted made two statutory requirements and three recommendations at the last full inspection. The provider had not submitted an action plan or response to the requirements to make clear the steps leaders and managers planned to take to meet statutory requirements. Progress has been made in addressing both requirements, but only one has been fully met. Clear and informative notifications are now made to relevant agencies in a timely manner. While there have been improvements in the frequency and quality of supervision, not all staff have received supervision in the timescales set out in the home’s own policy. Furthermore, agency staff used by the home do not receive supervision at all. As a result, not all staff are supported, directed, challenged or developed to deliver the best service to young people.

p.9

Leadership and management

Progress has been made to address the three recommendations made at the last inspection, but again not all have been fully met. The quality of supervision notes has improved. Handwritten notes allow records to be contemporaneous and result in signed copies at the time. Arrangements for the management of the home have changed since the last inspection when the former Registered Manager was spending only limited time in the home. Staff are now clear when the acting manager is available to them. Senior team leaders have also been appointed to take responsibility in the absence of the acting manager. Full records of recruitment and vetting checks continue to be stored at the head office nearby. While a check list has been developed and is stored within the home, this still fails to include all information stipulated in the national minimum standards.

p.9

Leadership and management

Recently, there has been a different approach to recording. Individual log books aim to reflect personalised targets for each young person and evidence the difference the home makes over time. However, training and preparation of staff has been ineffective, leading to varying standards of recording. Some staff write in a clear and informative style, providing an insight into the lives of young people; however, in some instances staff do not make a daily record relating to young people.

p.9

Leadership and management

Changes of staff result in a lack of continuity and consistency in the care of young people. The use of agency staff adds to the difficulty young people have in developing and maintaining relationships. New staff employed do not yet hold the expected minimum qualification. Core training is provided for new staff, who also undertake an induction process. Staff say this involves reading copious policies and procedures. However, records to demonstrate that staff have read and understood key documents are not kept within the home, but are stored on their personnel file at the head office. Appraisals of established staff have not taken place within the past year. Consequently, these staff do not receive feedback on their performance from managers or young people in their care. Individual strengths are not identified and personal development goals are not set.

p.10

Leadership and management

Changes in management have resulted in poor monitoring of practice, records and reviews of the quality of care. For example, restraint and sanction records are not monitored effectively. There has been no formal review of the quality of care for almost a year. The last review contained limited information as to how young people, parents or placing authorities were consulted, or how improvements in the service were identified. Reports of independent monitoring visits are not produced or reliably submitted on a monthly basis. They invariably reflect retrospectively on a preceding period, rather than provide a snapshot of the home at the time of a visit. Consequently, leaders and managers have limited understanding of the home’s strengths or areas where improvement is urgently needed.

p.10

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.

p.11

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.

p.11