Swanwick Lodge

Unique reference number SC038719 Inspection date 31/07/2013 Inspector Shaun Common / Philip Cass Type of inspection Full Provision subtype Secure Unit

p.1

Date of last inspection 22/11/2012 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 secure children's home is managed by a local authority. It is approved by the Department for Education to restrict young people's liberty. As well as the living accommodation, education is provided on site in dedicated facilities.

p.3

Brief description of the service

The children's home can accommodate up to 16 young people, who are aged between 10 and 17 years. Admission of any young person over the age of 10 but under 13 years of age requires the approval of the Secretary of State.

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 adequate .

p.3

Overall effectiveness

The secure unit has clear areas of strength that ensure young people receive good quality care and make good progress while accommodated. Young people have access to a range of health services and are supported to attend education. This results in positive health and education outcomes.

p.3

Overall effectiveness

The quality of care is good and there are excellent relationships between staff and young people. Young people feel able to complain and receive a timely response to any concerns they raise. Young people are supported effectively to develop skills for adulthood and for a positive transition back into the community. Contact with family is encouraged and young people receive visits and can make and receive telephone calls to people important to them.

p.3

Overall effectiveness

There is almost always an appropriate number of experienced and qualified staff on duty in order to care effectively for young people. However, formal supervision is infrequent, which does not adequately support staff in their work with vulnerable children.

p.3

Overall effectiveness

There are strong links with the Local Safeguarding Children Board (LSCB), and practices in the home ensure young people are kept safe. However, not all staff have up-to-date training in child protection in order to support them in their role. Young people assessed as vulnerable receive close care and support to keep them safe. However, risk assessments relating to self-harm lack some detail to guide relevant staff in actions required to promote the well-being and safety of young people.

p.3

Overall effectiveness

Young people are supported to develop positive social skills, behaviour and self- esteem. However, sanction records do not record the effectiveness, and as a result it can be difficult to determine if measures imposed are supporting young people to improve their behaviour. Physical restraint is appropriately used and is monitored. However, incidents are not always fully and robustly monitored to identify opportunities to improve practice further. External monitoring of the home is regular and assists staff to improve the quality of care provided to young people.

p.4

Overall effectiveness

Areas for improvement include: ensuring young people's meetings record action points and their outcomes; enabling young people to add their comments to sanction and separation records; ensuring staff involved in physical restraints are not involved in the debrief of young people; ensuring there is a formalised approach to the promotion of life skills; maintaining sanction, restraint and single separation records in tamper-proof formats; ensuring the room search policy is adhered to; and ensuring that single separation records are accurately kept.

p.4

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) ensure the children's home is conducted in line with the regulation; specifically that risk assessments pertaining to children at risk of suicide or self-harm are robust and fully implemented (Regulation 11(1)(a)) 30/09/2013

p.4

Reg. Requirement Due date

17B (2001) ensure that sanction records include the effectiveness of the use of the measure (Regulation 17(B)(3)(f)) 30/09/2013

p.4

Reg. Requirement Due date

(2001) ensure that at all times, there is a sufficient number of suitably qualified, competent and experienced persons working at the children's home; specifically ensure there is always sufficient staff on duty at any time to care appropriately for young people (Regulation 25(1)) 16/08/2013

p.4

Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate supervision (Regulation 27(4)(a)) 30/11/2013

p.4

Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate training; specifically, that all care and ancillary staff have up-to-date training in child protection and safeguarding children 30/11/2013 (Regulation 27(4)(a))

p.4

Reg. Requirement Due date

(2001) maintain the system for monitoring the matters set out in this regulation; specifically, ensure all matters in Schedule 6 are robustly monitored to ensure the quality of care provided improves. (Regulation 34) 30/09/2013

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 young people's views, wishes and feelings are acted upon, in the day to day running of the home; specifically, ensure that minutes of young people's meetings show clearly any action points and how these matters have been progressed and brought to a conclusion (NMS 1.1)  ensure that when any sanctions are used, children are encouraged to have their views recorded in the records kept by the home (NMS 3.18)  ensure that any child who has been restrained is given the opportunity to be debriefed by a responsible adult who has not been involved in the restraint incident and to talk through their experience within 24 hours (Volume 5, statutory guidance, paragraph 2.103)  implement a formalised approach for the assessment, development and promotion of skills for adulthood (NMS 12.1)  where staff resort to any measure of control or discipline or restraint, this is carefully recorded with full details by the staff involved within 24 hours in a

p.5

Recommendations

record kept for the purpose; specifically, ensure records of single separation, restraint and sanctions are in formats that can not be tampered with after the event (Volume 5, statutory guidance, paragraph 2.91)  implement fully the policy relating to room searches; specifically that a search of each young person's room is carried out at least weekly (NMS 23.3)  keep an accurate record of all uses of single separation (23.13)  ensure that young people are offered the opportunity to read and add permanent comments to the record of their separation. (NMS 23.13)

p.5

Outcomes for children and young people

Young people make excellent progress from the point of their admission to the home. This was verified by several professionals, including mental health specialists, a parent and an independent reviewing officer. Also the young people confirm how well they feel they have done since they arrived. Young people grow in self-esteem, and because the home is good at celebrating achievement, young people gain confidence in their abilities. As young people develop a more positive self-view, their aspirations increase and they look forward to success in adult life. Young people form stable and trusting attachments with staff. Staff help young people to manage their emotions and cope with anxieties. As a result, young people develop improved emotional resilience.

p.5

Outcomes for children and young people

Young people are helped to understand the issues that brought them to a secure setting. They are supported to make sense of their background and the effect it has had on their responses to difficult situations. Young people learn to understand the triggers that get them into difficulties and find more appropriate coping mechanisms.

p.6

Outcomes for children and young people

All young people attend education and make good progress. They undertake examinations and gain qualifications that will support them to move into further education and employment. Young people report that they have changed their attitude to school. Where they used to hate school, they now, ‘love it’. They have developed an understanding of the value of education and as a result are more likely to achieve educational success.

p.6

Outcomes for children and young people

One young person talked about how much he had gained from the education provision. Another young person shared his aspirations for employment in the future. He has realised during his time in the home that he has skills he can share with others. A parent said their child could not read or write, but has now taken GCSEs and believes there is a positive future for her upon release. Staff encourage young people to aspire to possibilities they could not previously imagine would be open to them.

p.6

Outcomes for children and young people

One of the strengths of the home is that young people are encouraged to be considerate of others, including their peers. One young person gave examples of how he has shared his football skills with another young person interested in the sport. Another young person has helped support peers in their learning in the classroom, in a similar way as a learning support assistant would in a lesson.

p.6

Outcomes for children and young people

Access to a range of good health care services means that young people have their health care needs identified and met. Consequently, they are healthier as a result of their placement at the home. Young people take strides towards addressing substance misuse concerns, are encouraged to consider a healthy diet and undertake regular exercise. Young people receive guidance and advice that help them to adopt a healthy lifestyle. Consequently, they learn to make positive health choices.

p.6

Outcomes for children and young people

Young people have good contact with family members and others important to them, including professionals. Parents are encouraged to visit their child and have daily telephone contact. Parents confirm that they are made welcome during visits to the home. Guidance is offered to ensure those who require financial support in this respect are referred to the relevant authority.

p.6

Outcomes for children and young people

Planning for resettlement commences from the point of admission. Young people are helped to prepare for this through planned and authorised visits into the community, known as mobility. This is well developed and good practice. Staff ensure young people are kept informed of plans for discharge and make every effort to prepare them practically and emotionally for the change of placement. Commendably, staff visit young people when they have left the home, offering on-going support. Staff recognise the importance of the relationships they develop with young people and endeavour to reach out to them when they are back in the community. During the inspection, a previous resident of the home some 10 years ago, who has maintained contact, was planning to meet up with several of the adults who had cared for him to celebrate a special occasion.

p.6

Outcomes for children and young people

Young people are provided with a card before they leave the home, which encourages them to keep in touch. The phone number and email address for the home are included. The questions on the card include; ‘whotcha doin now’? (sic) and ‘want to talk’, reminding them that although they have left the home, staff continue to be interested in their welfare and progress.

p.7

Outcomes for children and young people

Staff support young people to develop practical life skills, such as learning how to cook and taking responsibility for cleaning their living spaces. However, the approach to helping young people develop broader skills for adulthood lacks structure as an assessment of skills and formal recording of progress are not carried out.

p.7

Quality of care

Managers and staff show a high level of commitment to young people being cared for at the home. There is a very good understanding of the young people’s needs. Young people form trusting relationships with staff and are very complimentary about those working closely with them, particularly key workers. As a result, young people settle in quickly to home life and routines.

p.7

Quality of care

Comprehensive planning processes are in place to ensure all young people’s physical, social and emotional needs are identified and met. A personalised placement plan is produced for each young person, which is carefully discussed and agreed with them, their parents and relevant professionals. The delivery of placement plans is an aspect of the home’s work with young people that is excellent. This is supported by a team of mental health practitioners, including a consultant psychiatrist, a mental health nurse and a clinical psychologist, who are based on-site. These professionals are effective in delivering consultation and training for staff and in providing individual therapeutic interventions to young people as required.

p.7

Quality of care

The home has weekly multi-disciplinary team meetings and these are an excellent forum for thorough and detailed discussions about individual young people and group dynamics. The minutes from these meetings provide a very useful summary of the discussions about each young person’s needs. They are held as a central copy and any changes in plans of care are shared with relevant staff.

p.7

Quality of care

Care staff from each of the two residential living units meet with the consultant psychologist every two weeks to discuss the young people's needs. The aim is to work closely with staff to develop strategies for the provision of individualised care. New residents are discussed in detail and plans devised accordingly.

p.7

Quality of care

Staff identify young people’s diverse needs and ensure these are fully addressed. The only complaint young people have about any of their personal needs being addressed is that the home no longer has a hairdresser who can skilfully manage their hair. Attempts continue to be made to find an appropriate hairdresser for their particular type of hair, but in the meantime, family members are able to visit and provide this personal care to their child or sibling. This was seen as very positive by one parent spoken with during the inspection.

p.8

Quality of care

The health care needs of young people are assessed and addressed comprehensively. Young people have access to relevant professionals, such as a nurse, doctors, dentists, opticians and mental health professionals as required. Medication administration processes are safe and effective. Health assessment tools are effectively used by health care professionals and this supports good quality planning and care delivery, leading to young people having improved health outcomes.

p.8

Quality of care

Young people are very well supported to attend education. Effective morning routines mean that young people arrive on time and in a positive frame of mind. Good communication between education and care staff ensures that any barriers to education stemming from emotional and behavioural needs are addressed quickly. The home supports and prepares young people for transition to education in the community through established links with relevant external provision.

p.8

Quality of care

Young people have good opportunities to participate in activities and leisure pursuits. The young people are on a break from education for the summer, but a range of interesting enrichment activities are available to them. This includes activities such as Zumba, gym sessions, cooking, craft, art activities and rapping sessions. The enrichment programme is organised and led by a team of five learning support assistants from education, who work closely with care staff to deliver the activities. Young people learn new skills, have fun and improve their self-esteem and self- confidence as a result of the range of activities available to them. One young person, who will leave the home in the near future, intends to continue developing skills in sports he has been involved in at the home once he is discharged.

p.8

Quality of care

Young people are encouraged to meet regularly as a group to discuss their care and have a say about the running of the home. Records of these meetings are made to show young people are able to give their views on their care. However, action points are not always clearly identified and evidenced as being concluded to show young people's views have been carefully considered and acted upon where appropriate. There are a range of other processes in place to consult young people about changes to policy and practices. This includes having a separate group to review menus, and specific consultation about changes to the reward and incentive scheme. There is other evidence of changes being made as a result of listening to young people, which includes having clocks in their bedrooms and some items of jewellery, and changes to activities.

p.8

Quality of care

Young people are aware of how to complain. They have free access to complaints forms. They can obtain support from staff to complete complaint forms where required, or they can place their complaint in a secure box that is only opened by managers. Complaints are fully recorded and dealt with in a timely manner. Young people receive a response to any complaint and sign records to show the outcome has been explained to them and whether they are satisfied with the resolution. Young people are also offered the opportunity to take their complaint to the next stage if they remain dissatisfied.

p.9

Quality of care

The home is a pleasant and welcoming environment for young people to live. Young people take pride in their art work being displayed throughout. The home is well maintained and any issues related to the building are promptly identified and addressed by contractors. Young people like their bedrooms and are able to personalise them so that they feel comfortable in their own private space.

p.9

Safeguarding children and young people

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

p.9

Safeguarding children and young people

Young people feel safe at the home. Bullying does occasionally occur; however, this is managed effectively by staff. Bullying behaviour is addressed directly with the perpetrator and where appropriate, consequences for their actions are applied. Support is provided to young people who are the subject of any bullying.

p.9

Safeguarding children and young people

Each young person's needs are assessed on admission. Where this process identifies concerns about suicide or self-harm, a risk assessment is developed. These risk assessments are reviewed regularly and are implemented by staff in order to help keep young people safe.

p.9

Safeguarding children and young people

However, risk assessments pertaining to self-harm are not all as thorough or robust as they could be. They identify most matters of concern and action needed to keep young people safe. However, they do not clearly indicate how often night staff should check a young person who is vulnerable. Night care logs do show young people are checked regularly, but there is a lack of a clear link between the frequency of checks and the associated assessed risk. As night care staff undertake regular and recorded checks of young people, the impact of this matter is limited.

p.9

Safeguarding children and young people

The home has developed its policies and procedures relating to undertaking searches of young people's rooms, communal areas and the individual searching of young people to help keep them and others safe. Records are kept of all such matters. Young people are only searched via a 'pat down' for safety and security reasons where required and no search involves a young person removing their clothing. However, searches of young people's rooms are not always conducted in line with the home's policy. The policy states these will be carried out at least weekly, although this can be more often if there are risks to young people. The search records show that room searches are not always carried out at least weekly. The impact of this is limited as regular searches are carried out and anything found is recorded and removed if it is a risk to a young person.

p.9

Safeguarding children and young people

The home has developed an appropriate and specific child protection procedure and guidance for staff to follow if there are concerns about a young person. This is implemented in practice as required in order to ensure young people are safeguarded. There has been one child protection matter since the last inspection, which was referred promptly to the local authority child protection team and the local authority designated officer (LADO). The records of this matter are clear and detailed. It shows all steps taken and how the matter was brought to a satisfactory conclusion in the interests of protecting a young person.

p.10

Safeguarding children and young people

The acting manager has strong links with the Local Safeguarding Children Board (LSCB). She is a member of a sub-committee of the Board, working with them to improve safeguards to young people in the area. The manager also has good links with the LADO in order to improve the safety and well-being of young people. The home provides regular information on physical restraint to the LSCB; this ensures the Board maintains oversight of the home's work, helping them to improve practices.

p.10

Safeguarding children and young people

The home has a well-established incentive scheme that young people know and understand. The scheme has various levels through which young people can progress. This starts with pre-bronze level then moves on to bronze and through to platinum-plus. Each level has progressive rewards and benefits which encourages and supports young people to develop positive social skills and behaviour.

p.10

Safeguarding children and young people

Where negative behaviour is exhibited, staff impose sanctions upon young people. Sanctions used are varied and appropriate, and records are kept. However, the effectiveness of the measure is recorded inconsistently. This means that managers cannot be clear that the sanctions imposed are having the desired effect of stopping poor behaviour and supporting young people to develop positive behaviour and social skills. Additionally, young people do not always have the opportunity to have their comments recorded on these records so that they develop understanding and responsibility.

p.10

Safeguarding children and young people

Physical intervention is used appropriately and no pain-compliance methods are employed at the home. Physical intervention is carried out when required by trained staff, to ensure young people are kept safe. Records are kept of each incident. Young people are afforded the opportunity to make comments on these records about the incident and are also offered the opportunity to see a health professional after the event. Young people are offered a supportive debrief after each incident. However, it is not always with a member of staff who has not been involved in the restraint, which is not best practice or in the best interests of young people. The acting manager monitors all restraints. Every incident is reviewed using closed circuit television, which helps to promote the safety and well-being of young people. However, there are some incidents deemed appropriate by the acting manager, that would have benefited from further examination. These are related to where further

p.10

Safeguarding children and young people

exploration could have identified possible alterative response but are not directly related to the safety or well-being of young people. The home's policy in the use of single separation is commensurate with government guidance in that young people are only to be placed in single separation when there is a risk to themselves, others, or there is significant damage to property. Its use by staff is appropriate. However, there have been limited occasions when young people have remained in single separation when the criteria for this course of action no longer applies. The new acting manager and new acting assistant manager have recognised this and ensured this practice has ceased. They have also taken action in briefing staff on expectations and ensuring that single separation can only be used or continue to be used, when authorised by the acting manager or acting assistant manager.

p.10

Safeguarding children and young people

Full records are kept of all single separation events and these show that young people are closely monitored during periods when they are locked in their rooms, to help keep them safe. However, records in some cases do not clearly show that the criteria for single separation, as stated in the policy, have been met. Review of these records and practice indicates that these are some recording errors. Young people do not always have the opportunity to write their comments in these records or sign each entry, which would help to promote their rights.

p.11

Safeguarding children and young people

Restraint, single separation and sanction records are all kept as loose leaf documents that are not tamper-proof. They are not kept in the manner set out in statutory guidance to ensure information of this nature is secure and promotes young people's rights.

p.11

Safeguarding children and young people

Since the last inspection, there has been one incident where a young person has absconded during a planned visit in the community. The home now has an appropriate procedure and protocol with the local police that is directly relevant to the young people accommodated at the home. The procedure was followed by staff and all action taken to ensure the young person was found and returned to the home quickly with appropriate follow-up support.

p.11

Safeguarding children and young people

Six new staff have been recruited since the last inspection. The home has a clear process in place for the safe recruitment and selection of new employees. This helps ensure that the right people are employed to work with vulnerable children.

p.11

Leadership and management

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

p.11

Leadership and management

The Registered Manager has just left the service. However, an acting manager and an acting assistant manager are in post. Staff report that they have confidence in the new management team. The new manager understands her obligation to apply for registration with Ofsted.

p.11

Leadership and management

At the last inspection, five requirements and 17 recommendations were set. The home has addressed a number of these and the service has improved in a number of areas. This includes: risk assessments, complaint processes, health care, medication systems, information provided to young people, and care planning. These matters have helped to improve the care, safety and well-being of young people.

p.11

Leadership and management

However, a number of statutory requirements and recommendations made at the previous inspection have not been fully addressed. This means that service development for the benefit of young people is limited. For example, records of sanctions and single separation have not improved. This reduces the capacity of managers to evaluate the suitability and effectiveness of measures of control. Although there are improvements in the frequency and quality of supervision, the home does not ensure that all staff are regularly offered formal guidance and support. Management monitoring of key issues including single separation and restraint is not sufficiently robust. Quality assurance processes do not always identify or respond to shortfalls in practice.

p.12

Leadership and management

The home's Statement of Purpose provides detailed information to parents and placing authorities about the services available. A children's guide is available to young people, which provides them with good information about the home and what to expect. Young people are consulted about the design and wording of the children’s guide. This means that it is accessible and easy to understand for all young people admitted to the home.

p.12

Leadership and management

There is an appropriate number of staff in order to care effectively for young people and ensure good outcomes and good quality of care. However, there has been one occasion where due to insufficient staff, young people were in their rooms longer than usual. Rather than being allowed into communal areas from early morning, it was after lunch before sufficient staff were available and before young people could go about their normal routines. This was due to an emergency that resulted in a young person requiring hospital treatment. Other staff could not be secured to work at the home that morning. Action has been taken to avoid this situation occurring in the future.

p.12

Leadership and management

Staff benefit from a range of training that supports them to provide good quality care to young people. This training includes first aid, physical intervention and administration of medication. Service specific training has been developed in relation to self-harming behaviours and the home’s model of care. Staff demonstrate a good understanding of safeguarding procedures. However, a number of staff have not received refresher training in safeguarding. External monitoring of the home is good. The home is visited each month by an independent person and a report is provided to the home and Ofsted. Reports assist the home to improve the quality of care provided to the young people. However, internal monitoring by the manager is not sufficiently robust.

p.12

Leadership and management

Management response to complaints or concerns about the service is thorough and effective. Where appropriate, the home uses independent investigators. This ensures that complainants can be confident of a fair and impartial review of the concerns raised. The home has also made significant progress in strengthening performance management and absence management systems. Where work practice issues are identified, managers are assertive in setting and monitoring improvement objectives. A stronger working relationship with human resources professionals means that absenteeism is significantly reduced. This improves the consistency of care provided to young people.

p.12

Leadership and management

A development plan is in place. It highlights how the home intends to improve the quality of service provided to young people. The development plan has been used effectively to drive improvements in multi-agency working, rota management and consultation with young people.

p.13

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.14

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.14