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

Unique reference number SC358638 Inspection date 01/05/2013 Inspector Linda Brown Type of inspection Full Provision subtype Children's home

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Date of last inspection 17/12/2012 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

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 are cared for by staff who are motivated and committed to providing them with a good quality of care. Staff’s enthusiastic practice assists young people in making good progress in relation to their starting points. Young people's individual needs are met and this enables them to achieve positive outcomes and reach their full potential.

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Overall effectiveness

The atmosphere in the home is calm and friendly. Young people state that they feel safe and are happy at the home. All aspects of care planning are personalised to meet the individual needs of the young people. Wherever possible young people contribute to the decisions being made about their lives and their views are taken into account when completing care plans.

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Overall effectiveness

Young people benefit from the positive relationships they develop with staff. The stability and consistency of staff is a key factor to the success of the home, enabling young people to form trusting relationships. Staff are child focused and spend a large proportion of their time talking to and completing activities with young people.

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Overall effectiveness

Clear boundaries are in place and young people are aware of the expectations and rules of the home. Young people are kept safe from harm by good risk assessments, robust recruitment practice and staff awareness and understanding of young people’s behaviours.

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Overall effectiveness

The manager is aware of the home’s strengths and weaknesses. Good internal and external monitoring takes place. Action plans address any identified shortfalls. However, copies of monitoring reports received at Ofsted do not demonstrate how the home is improving the quality of care provided to young people. Five recommendations are made as a result of this inspection with regard to staff training, the admission process, repairs, internal monitoring reports and the decision making process after a notification has been made.

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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 home provides a comfortable and homely environment and is well maintained and decorated, this is with particular regard to ensuring damage is promptly repaired (NMS 10.2)  ensure that the children's home only provides admission to children whose assessed needs they can reasonable expect to meet (NMS 11.3)  ensure staff are equipped with the skills required to meet the needs of the children and purpose of the setting with particular regard to specialist training (NMS 18.1)  ensure the manager regular monitors, all records kept in the home to identify patterns and trends and demonstrate how the quality of care provided in the children's home is improving, with particular regard to providing reports to Ofsted (NMS 21.2)  ensure a written record is kept which includes details of the action taken, and the outcome of any action or investigation, following a notifiable event, with particular regard to the decision making process to return staff to work at the

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Recommendations

home after an investigation has taken place. (NMS 24.2)

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Outcomes for children and young people

Young people benefit from a staff team who provide them with individual support in order to develop confidence and a positive view of themselves. Young people often arrive at the home in crisis, struggling to cope with home life, school or a break down at another residential placement. As a result, some young people display behaviours that can be damaging to themselves and others.

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Outcomes for children and young people

While living in this home young people become more confident and make progress in developing their self-esteem. This is evidenced by a significant reduction in self- harming and risk taking behaviours.

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Outcomes for children and young people

Young people state that they feel safe and secure at the home. They develop supportive and nurturing relationships with staff. This enables them to feel confident to raise any concerns they may have. Staff have a good knowledge and understanding of the needs and behaviours of the young people. Behaviour is well managed; staff actively promote positive behaviour by continual reassurance and praise supported by reward programmes. This supports young people to feel valued and respected by staff which helps to increase their self-esteem and reduce any negative and harmful behaviours.

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Outcomes for children and young people

Young people are supported to maintain contact with their families, friends and significant adults in their lives. Parents speak positively regarding the welcome and support they receive. Staff recognise the importance of family contact and work closely with families to develop their skills in order to facilitate where appropriate increased contact or successful return home. For example, one parent recently joined staff for some specialist medical training. This enables young people to make progress in developing and sustaining relationships.

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Outcomes for children and young people

Young people demonstrate a good understanding of the importance of living a healthy lifestyle. Staff spend time with young people talking about the benefits of healthy living and the long-term effects of risk taking and harmful behaviour. As a result of this practice, young people who were previously taking drugs and alcohol are no longer engaging in this habit.

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Outcomes for children and young people

The manager is committed to supporting young people back into education and from the time of a young person’s admission she liaises with the appropriate professionals to ensure an appropriate placement is identified. At the time of placement some young people have encountered several educational breakdowns. As a result, young people who had very poor attendance prior to living at the home are now engaging with staff and looking forward to achieving success in their placement.

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Outcomes for children and young people

Young people develop their independence skills at a level that is appropriate, taking into consideration their individual needs. Staff engage young people in a range of tasks from menu planning, shopping, budgeting and cooking to keeping their rooms tidy and general chores around the house. This gradual introduction into independence prepares them well for future semi-independent living and adulthood.

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Quality of care

Children and young people receive a good quality of care which takes into account their cultural background and personal identity including their age, gender, religion, ethnicity, communication needs and their sexual orientation.

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Quality of care

Plans are in place to provide staff with a detailed understanding of the needs of individual young people and the services provided for ensuring that those needs are met. Risk assessments support the plans by giving clear guidance on how to manage specific behaviours. Records are regularly reviewed and updated to ensure that they reflect young people’s current needs. Staff work closely with young people to support them to attend their meetings and ensure plans reflect their views and wishes. Families and social workers are also consulted regarding the young people’s plans, resulting in close working relationships being formed with positive outcomes for young people. A comment received from a parent confirms this view, 'The staff are really good here, they make me very welcome and my child is happy here.’

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Quality of care

Staff regularly seek the views of young people regarding all aspects of their lives. Young people confirm that they are consulted regularly. They state they can approach staff at any time and staff will listen and take action to address any concerns they may have. Regular discussions take place giving young people the opportunity to openly discuss their feelings, wishes, concerns, anxieties and worries. Equally staff spend time with young people explaining why their requests cannot always be met. Young people are further supported with contact from an independent advocate who will, when required, advocate and challenge decisions on the behalf of the young person. This practice provides young people with the opportunities to discuss their views and opinions. In addition, it also provides a safe external adult for young people to talk to which helps to protect them from the risk of harm and abuse.

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Quality of care

Young people are supported and encouraged to develop positive and constructive relationships and behave appropriately. Staff demonstrate a good understanding of the moods, behaviours and body language of the young people and this knowledge enables them to adapt the care they provide to meet individual needs. A range of strategies are used to defuse potentially challenging situations. As a result of the consistent implementation of the rules and boundaries combined with reward charts, praise and encouragement from staff, there is a significant reduction in the challenging and destructive behaviour being displayed by young people. It is evident that young people are learning strategies to manage their own behaviour. Although situations still arise, young people are developing the skills to reduce the severity of the incident and where appropriate remove themselves from situations to calm down. The introduction of debrief sessions has been extremely successful giving

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Quality of care

young people the opportunity to reflect on situations, discuss their feelings and any issues they may have.

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Quality of care

Comments made by parents praise the staff for the support and progress their children have made due to the implementation of boundaries and routines. Social workers speak highly of staff commitment and creative approach to providing individualised packages of care.

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Quality of care

Health needs are identified within the placement plans. A range of support services are available to address the individual needs of the young people. Medical advice and professional help is sought to support young people to reduce habits, such as, smoking, alcohol and drug taking. This is balanced with the benefits of healthy eating and regular exercise. Young people are involved in shopping, preparing and cooking food. Medication is administered, stored and disposed of appropriately. Only staff who are appropriately trained administer medication. Medication records are maintained and monitored by the manager.

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Quality of care

The educational needs of the young people are fully supported. Management and staff work closely with young people and education providers to ensure that young people are provided with the appropriate provisions to enable them to reach their full potential. Trying to find suitable placements for some young people who are above school age is at times very challenging. Social workers praise the work of the management and staff who despite the challenges are totally committed to identifying placements where young people will achieve success. Significant steps have been made when judged from a young person’s starting point to address this situation. Placements are now identified for young people, although, some placements do not start until July 2013. Young people speak positively about the placements and the work they will be doing. In the meantime staff encourage young people to attend basic core skills education and build in educational and life skill

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Quality of care

tasks while waiting for the placement to start. As a result, places on suitable educational work programmes are secured providing young people with the opportunities to reach their full potential.

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Quality of care

Young people's achievements are celebrated. The ethos of this home is to reward success in all aspects of the young people’s lives no matter how small the achievement. Certificates and awards from in-house achievements are displayed at the young people’s request. Young people speak with pride regarding the awards they have received. This practice supports young people to develop their self-esteem and a positive self-view.

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Quality of care

Young people enjoy varied and purposeful activities in the home and the wider community. They make good progress in developing their social skills. In addition to in-house activities young people are encouraged to pursue their individual hobbies and interests; for example, football, swimming and attending a local youth club and gym. Through their activities young people learn how to interact socially with their peers and with adults which helps them to prepare for adulthood.

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Quality of care

The home is clean and well maintained providing a safe environment for the young people. There has been a significant amount of damage due to some of the behaviours displayed and a decision was made by management to reduce the risk of injury, for example, from ornaments, glass and china by removing them. The communal areas are quite minimal although clean and comfortable. This situation is constantly under review. Young people’s bedrooms are personalised with posters. The management and staff take immediate action to report and replace any items that are damaged. Emergency repairs are completed immediately however, the maintenance process for non-emergency work can at times pose delays. For example, a young person’s bedroom door frame and plaster work around the door is broken and missing along with a fence panel from the back garden. This constant reminder of the damage that has been caused does not encourage young people to

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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 safe at the home. Feedback received from families and professionals commented on the good work that staff do to keep young people safe. Staff demonstrate a good awareness of the safeguarding procedures which are implemented into their day-to-day practice. Staff are all aware of the whistle-blowing procedure and are clear that they would have no hesitation in following the procedure in order to protect young people. Robust risk assessments provide guidance to staff on how to ensure that young people are kept safe in all aspects of their lives. Staff are mindful of the risk and dangers to young people while out in the community. Staff support young people to have free time away from the home but ensure strategies are in place to provide young people with support. For example, regular mobile telephone contact and when agreed, observational checks are made.

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Safeguarding children and young people

Young people are confident they would tell staff if they were concerned about anyone or anything. Although there is minimal risk of bullying at this home, work still takes place with young people to provide them with an understanding of all aspects of bullying to include the feelings and issues of the bully and the victim.

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Safeguarding children and young people

The atmosphere at the home is relaxed and calm and the emphasis among the staff team is to defuse any potentially difficult and challenging situations. Some of the behaviour displayed by young people at times can be extremely challenging and difficult. Behaviour support plans identify a range of behaviours and provide information to staff on how to manage difficult situations in a consistent and appropriate manor. These documents are regularly reviewed and updated. Daily routines provide young people with structure to their day. Reward charts are created with young people, progress and achievements however small are celebrated. This practice is improving behaviours and incidents involving challenging and harmful behaviours are being reduced.

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Safeguarding children and young people

Relationships between staff and young people are built on trust and respect and this means that young people feel confident and secure. Physical interventions are used when all other options to defuse situations have failed. In the event of a physical intervention detailed records are maintained. Due to the relationships between staff and young people and the strategies in place there is a significant reduction in the escalation of challenging behaviour and as a consequence a reduction in the need to use any physical interventions.

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Safeguarding children and young people

Debrief sessions are held separately with both staff and young people after any incident of physical intervention. Young people are given the opportunity to reflect on their behaviours and the action staff took to resolve the situation. These sessions provide excellent reflection on the incident and enable both staff and young people to discuss their feelings and concerns. As a result young people understand the consequences and learn strategies to manage their own behaviours.

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Safeguarding children and young people

Young people are protected and are cared for by staff that understand their vulnerability and are aware of the procedure to follow in the event of a young person going missing. Links are established with the local police so they have a good understanding of young people’s vulnerabilities and any potential risks. Staff confirm that immediate action is taken to look for young people if they go missing and return them safely to the home. This approach, combined with the relationships being formed between staff and young people, has resulted in minimal incidents taking place.

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Safeguarding children and young people

Young people are further protected by good health and safety routines and safe recruitment of staff. Regular fire tests and drills take place and equipment is checked and serviced within the required timescales. Young people are aware of the fire procedures. Additional measures have been introduced to look at and reduce the risks of young people inappropriately smoking in the home. These include discussions with young people, consultation with the fire officer and the provision of additional smoke detectors in the home.

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Safeguarding children and young people

Robust staff recruitment takes place in line with the provider’s recruitment and selection procedures. Visitors sign in and are checked on arrival and where appropriate identification is required.

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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

The manager is committed to improving the lives and outcomes for the young people who live at the home. She is able to demonstrate a good understanding of the strengths and weaknesses of the service and the action she has taken to address the shortfalls.

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Leadership and management

Three requirements were made at the previous inspection regarding health and safety, behaviour management and staffing. Action has been taken to address all three. New health and safety procedures have been implemented regarding young people gaining access to the office and keys. Health and safety repairs have been carried out in the garden. The improvements to the continuity of staff were implemented in the past month. Therefore, all requirements have been met.

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Leadership and management

Six recommendations were made regarding monitoring, young people's views and staff supervision. Action has been taken to address all six recommendations. Monitoring visits are undertaken monthly by an external visitor to monitor the overall care and welfare of the young people. The quality of these reports has been addressed and the manager responds immediately to any actions raised as a result of these visits. Internal monitoring reports are completed and submitted to Ofsted every six months as required. Although, these reports lack an analysis of the service to demonstrate how the manager is improving the quality of care in the home, there are good systems in place to monitor the daily lives of young people and pick up any patterns and trends.

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Leadership and management

The Statement of Purpose sets out the aims and objectives for the home and provides young people, families, carers and professionals with detailed information about the home. This document is regularly reviewed and updated.

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Leadership and management

Placements are planned at the home, however, without a core staff team it is difficult to risk assess the needs of the young people against the skills of the staff team. This resulted in young people with identified specialist needs, being moved into the home with staff who do not have training in specific areas such as self-harm and epilepsy. The manager has actively sort this training and provided a range of information for staff. However, this shortfall leaves young people vulnerable if risk assessments are not completed at the time of referral to ensure the staff have the appropriate skills to meet the needs of the young people.

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Leadership and management

At the last inspection, a requirement was made regarding the supervision and continuity of staffing. Until recently, this has remained an on-going concern, as it is common practice for staff to work at several other homes owned by the provider. Staff supervision was not consistent and not always completed in the same home by the same manager. However, since April 2013 a core staff team is in place providing a balance in terms of experience, age, gender and ethnicity. This consistency has already resulted in positive outcomes for young people, with a significant reduction in incidents. A commitment has been made by the provider to maintain this core staff team at the home. Supervisions are now taking place providing the manager with the opportunity to look at consistency, staff practice and training. The team is in its early stages of development. The manager is keen to build on its strengths and improve

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Leadership and management

and address its weaknesses in order to develop staff practice to provide a consistent and effective service to young people. The manager takes an active role in the day- to-day management of the home and as a result, staff feel well supported by a manager who is easily accessible.

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Leadership and management

Young people are cared for by staff who are enthusiastic and motivated to develop their practice and skills to improve outcomes for young people. Staff have completed their mandatory training and are either completing their induction, enrolled on or have achieved their Level 3 Diploma in Health and Social Care. Some specialist training, for example, epilepsy awareness has recently taken place and specialist training in other areas, such as, self-harm is being sourced. However, the lack of specialist training in areas such as self-harm compromises the good work taking place.

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Leadership and management

Young people’s records are up-to-date, well maintained and stored in a suitably secure place. The manager demonstrates an understanding of the importance to pass information about serious events to the relevant professionals through the notification process. There is a procedure to move staff from a home if a concern or complaint is made pending a full investigation. Clear records are available regarding the decision making process and the outcomes regarding any concerns that are passed on to safeguarding professionals. Policies are in place and are routinely implemented. However, the decision making process to reintroduce staff back to the home is not fully recorded and this compromises the otherwise transparent and detailed system in place.

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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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