Children's Home run by Hillcrest Children‟s Services (2) Limited in Shropshire

Unique reference number SC398391 Inspection date 04/07/2013 Inspector Trevor Hall Type of inspection Full Provision subtype Children's home

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Date of last inspection 29/10/2012 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

This home is part of a range of children's services within a private care organisation. It is registered to accommodate three young people 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 experience a good standard of care because staff provide consistency, stability and a safe nurturing environment. As a result, young people are supported to achieve good outcomes, particularly with regard to their education and preparation for independent living. The home works hard to ensure young people receive effective healthcare, assessment, treatment and support that reflect their particular needs. The home is particularly resourceful in managing a clear framework for behaviour while celebrating and encouraging appropriate individuality. Priority is given to helping young people develop their sense of self-worth and to help them to maximise their educational and personal development.

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Overall effectiveness

Safeguarding young people's welfare is placed at the highest priority, both in terms of the health and safety of the environment and promoting young people’s physical and mental well-being. Effective internal and external monitoring processes provide continuous quality assurance which helps to maintain the home's good standard of care and assists in promoting the on-going improvement of the service.

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Overall effectiveness

The home is very effectively managed; this has done much to focus the work undertaken and to place the young people at the very centre of the home's function. Risk-taking behaviour, self-harming behaviours and unauthorised absence from the home have all increased since the home was last inspected. However, this reflects young people's struggle to appropriately deal with their changing circumstances and the anxieties that these entail, rather than any deficiency in practice. Staff remain aware of the individual reasons why young people may go missing or self-harm, and use this insight to minimise both opportunity for and consequences of such actions. Staff acknowledge that they receive generally good support, guidance and direction from the Registered Manager; however, the provision and recording of staff supervision do not always confirm that required frequencies have been maintained.

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Overall effectiveness

The trusting and sincere relationships observed between young people and staff are based on mutual respect and honesty. Young people receive good on-going care and support from a care team that is dedicated, hardworking and committed to achieving the best possible outcomes for them. The home has an energetic, motivated and well-qualified manager, who leads by example and is ambitious to achieve the best possible outcomes for the young people in her care. Rigorous monitoring of care delivery, through well-maintained recording systems, ensures that both strengths and weaknesses are identified and effective remedial action is taken.

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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 a written or electronic record is kept by the home detailing the time and date and length of each supervision held for each member of staff, including the registered person. The record is signed by the supervisor and the member of staff at the end of the supervision. (NMS 19.5)

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Outcomes for children and young people

Young people clearly benefit from the security and structure that exists within this home. Boundaries are consistent and help to give young people a feeling of security without denying them their individuality. They enjoy generally positive relationships with the staff group. These relationships are based upon mutual respect and positive regard; this helps the young people to build up their emotional resilience and improve their self-image

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Outcomes for children and young people

Young people make good progress in relation to their individual starting point, within a nurturing and safe environment. Young people learn to appreciate the significance of differing values and cultures and to have respect for other people because staff promote a positive ethos that fully embraces diversity and difference. Young people express their feelings and emotions. This promotes positive behaviours, assists young people to understand the consequences of their actions, and encourages alternative and more acceptable responses.

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Outcomes for children and young people

Young people enjoy a healthy lifestyle, take regular exercise and choose to eat healthy food options. New and different food options are regularly introduced to the home’s menu to expand young people’s food experience, nutritional knowledge and confidence.

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Outcomes for children and young people

Young people's attendance and educational attainment are high and they build on their knowledge and skills. They develop a good work ethic and acquire the values they need to help them stay fully engaged in their education.

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Outcomes for children and young people

Young people enjoy a good range of activities both in the home and out in the community. This gives young people opportunities to develop their social skills and increase interactions with peers and the wider community.

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Outcomes for children and young people

Young people maintain helpful and close relationships with important people in their lives. Particular attention is given to planning and organising family contact, and staff listen to young people and family members in order to achieve arrangements that are appropriate and safe.

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Outcomes for children and young people

Young people learn about personal responsibility and growing independence. The staff team is committed to providing young people with individualised support, focused on their personal development and individual circumstances. Staff prioritise the work they do with young people in terms of life skills and future plans.

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Quality of care

Young people benefit from individualised programmes of support, in line with their identified needs, including those relating to culture, religion, language and race. Comprehensive care planning identifies areas for development based upon young people’s individual needs, skills and abilities. Staff work consistently to address these individual needs and promote young people’s emotional and physical well-being. Staff display very good communication skills and young people confirm that they feel listened to and are actively involved in their care. The staff group provides the right balance between nurturing and enabling young people to develop appropriate self- reliance.

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Quality of care

Young people’s care needs and development are reviewed regularly as a means of acknowledging the progress they have made and any changes in circumstances. Staff, young people and, where appropriate, their families are assisted to contribute their opinions. This ensures that all decisions are known and understood by all and can be implemented effectively into the daily living arrangements.

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Quality of care

Young people benefit from generally good relationships with a very supportive and caring staff team. Meaningful and sustainable relationships have been developed, based upon mutual respect and trust developed over time. Relationships are occasionally strained and minor damage to property, unauthorised absence and self- harming behaviours have occurred. With the exception of self-harming behaviours, however, these are not common events within the home and have diminished over time. Communication between staff and young people is good, which results in staff being able to respond effectively; this ensures that young people’s needs and wishes are well known. Young people have regular meetings with their key worker to discuss progress and any issues of concern. They confirm that they are encouraged and supported to make decisions about their lives in line with their individual needs. As a result, they feel valued, take ownership of their placement and actively influence the

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Quality of care

running of the home. Young people present well, are appropriately dressed and have sufficient belongings to meet their needs. They receive pocket money and appropriate allowances to help purchase clothing and toiletries of their choice.

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Quality of care

Clear policies and procedures effectively and consistently applied by an appropriately trained staff team effectively safeguard young people’s health. Vigilant checking in and dispensing of medication ensures accurate and up-to-date records, which evidences safe practice.

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Quality of care

Young people live in an environment where their individual health needs are identified and services provided to meet them. Individual care files contain health information and details of each young person’s General Practitioner, dentist, optician and specific external specialists. Staff support and encourage young people to access external health professionals in line with their identified need. Clearly maintained records of appointments with health professionals, evidence that the physical, emotional and mental health needs of the young people are effectively met. Placement plans are updated when health needs have been met, or when new issues are identified. This helps the staff team monitor young people’s emotional and physical well-being and ensures continuing good health and development. Staff support young people to take charge of their own health care to better prepare them for independence and adulthood.

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Quality of care

Staff have high expectations of the young people in their care and high levels of educational attendance and attainment are encouraged. Staff support young people’s education and liaise regularly and effectively with the schools they attend; this ensures that young people achieve positive outcomes. Despite having previously experienced considerable difficulties in sustaining education placements prior to living at the home, young people’s attendance is good and attainment has improved. Young people speak positively of their education and the support and encouragement they receive.

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Quality of care

Young people are actively encouraged to pursue their own particular interests, and to try new activities. This increases young people’s experiences and helps them to enhance their confidence and their social skills and abilities.

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Quality of care

Young people enjoy living in a rural area, in a home which provides sufficient space to meet their needs. The home is decorated to a good standard and young people have good quality furniture in their bedrooms and ample storage for personal clothes and belongings. Each young person has their own bedroom and they are encouraged to make them as comfortable and personal as possible. The home enjoys good links to local facilities and is within easy reach of good transport links. The home provides transport so that young people are able to participate in a range of purposeful and enjoyable activities, to go shopping and attend contact visits with their families. The outside environment is good; the home has extensive gardens to the rear and side of the property which are available for young people's recreational use.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people confirm that they feel generally safe living in this home. The home has a set of comprehensive individualised assessments of risk for the young people in residence. These cover aspects of their potential behaviour, self-harm, the environment and the activities they wish to undertake. Risk assessments are proactive, identifying potential risks and providing effective strategies to help to minimise these.

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Safeguarding children and young people

Self-harming and extreme risk-taking behaviours are acknowledged features of some of the home's current residents. These behaviours have been comprehensively risk assessed and strategies, agreed as part of the individual care plans to challenge them and promote individual safety, are in place. While self-harming behaviours have increased of late, appropriate support is being provided to the young people by specialist outside agencies, such as the child and adolescent mental health service, and regular access to the company's therapy team.

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Safeguarding children and young people

Young people confirm that the use of physical interventions is infrequent, only being used as a last resort, by staff, to ensure safety for all. The resolutions of most incidents are through the skilful application of staff support and the sensitive use of conflict resolution techniques. The home’s manager monitors each intervention, ensuring that the intervention is necessary, applied correctly and comprehensively recorded. The manager also ensures that young people are aware of their right to complain, receive any medical attention if required or requested and that social workers and, where appropriate, parents are fully informed.

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Safeguarding children and young people

Staff, guided by other relevant professionals, work hard to enable young people to moderate and improve their behaviour. Young people confirm that the use of sanctions is minimal, fair and consistent. Young people understand that the boundaries in place are there to ensure their safety. They are invited to sign all records relating to the use of sanctions, which helps them develop understanding and responsibility.

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Safeguarding children and young people

There is an emphasis on recognising and rewarding positive behaviours, rather than purely punishing those behaviours identified as being unacceptable. This enables young people to develop more socially acceptable behaviour and better prepares them to interact positively with the wider community.

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Safeguarding children and young people

Positive relationships with the local police and the application of established protocols enable staff to manage unauthorised absence extremely well. Episodes of unauthorised absence have increased since the last inspection as some young people have struggled to deal positively with their changing circumstances and the anxieties that these entail. Staff remain aware of the individual reasons why young people may go missing and use this insight to assist them in managing their feelings and frustrations in a more productive manner.

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Safeguarding children and young people

Staff receive regular and wide-ranging training in safeguarding. As a result, they demonstrate a comprehensive understanding of the action they should take should they have any concerns about a young person's safety or well-being. Effective working with external partners, such as the Local Authority Designated Officer, ensures the continued development of staffs’ knowledge and understanding of child protection practice.

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Safeguarding children and young people

The home has a good range of detailed policies and procedures covering aspects such as prevention of bullying, the processing of complaints, safeguarding young people and behaviour management. These policies and procedures are applied consistently by a well-trained staff team that receives regular updates to their training that ensures young people are effectively protected from abuse. The regular and effective monitoring of the home's records and staff practice, by the home’s Registered Manager, ensures that young people receive safe care in line with their individual needs.

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Safeguarding children and young people

The home has a vigorous health and safety regime, which ensures that all fire precautions, drills and equipment servicing are conducted routinely, consistently and within timescales set by the relevant regulations. Good staffing levels further help to keep young people safe and reduce any risk of harm. The organisation’s effective recruitment procedures ensure the careful selection, recruitment and retention of staff. New staff are comprehensively vetted prior to their deployment in the home and before having unsupervised access to any young person. This ensures young people are safe and have a staff team who know them well.

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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 home's Registered Manager is suitably qualified and experienced and provides the home with strong, visible leadership which promotes a good quality of care and promotes positive outcomes for young people. Staff are well supported which means they provide a good quality of care tailored to address the individual needs of the young people in residence. Honest dialogue and supportive care help young people learn from their mistakes. As such, young people make significant progress and are challenged about the way they react to others and about the choices that they make.

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Leadership and management

The home's structure successfully fosters a sense of social awareness and promotes mutual respect between individuals within the home and wider community. Regular team meetings provide staff with excellent opportunities to discuss the needs of the young people and to be fully involved in the development of the service. Generally staff supervision is both consistent and regular and most staff expressed satisfaction with the frequency and quality that they received. Some, however, suggested that records of supervision do not always accurately reflect the real frequency and that deployment to other homes, holidays and care delivery commitments mean that they do not always get the level of support that they feel they should.

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Leadership and management

The home has a clear and accessible Statement of Purpose and young person’s guide that gives young people, their families and placing authorities comprehensive information about the services offered by the home. The financial viability of the provider is clearly evidenced in the high level of resources committed to the home. Young people confirm that they are treated with respect and dignity and are supported by staff to overcome their individual issues.

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Leadership and management

All staff members comment positively about the manager’s commitment and child- centred approach. Clear lines of accountability in the home have enabled a stable, consistent and structured environment to be established. Staff duty rotas confirm that the home keeps sufficient staff on duty at all times. The home has a very good system for dealing effectively with young people’s complaints. Young people confirmed their awareness of the home’s complaints system and stated they would use it with confidence.

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Leadership and management

Staff are provided with a good initial induction, further training, support and resources and therefore have a good understanding of the developmental needs of the young people in their care. Staff training covers all mandatory areas such as safeguarding, behaviour management and first aid, as well as specific training indicated by the identified needs of individual young people.

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Leadership and management

The staff team works proactively to help young people to achieve positive outcomes, overcome barriers and to enhance their well-being. Good staff communication ensures that staff are consistent in the care they provide, which ensures young people's individual needs are well met. Young people take an active part in the running of the home and they are encouraged to make their views known, through discussions with staff and by attending house meetings. Staff ensure that a safe, secure and nurturing environment is maintained which assists young people to make real progress and to fulfil their individual potential.

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Leadership and management

The manager has established rigorous internal quality assurance monitoring systems. It is clear that she checks all reporting systems regularly and comments if any record fails to meet either the home's policies and procedures or national regulations. Regular internal monitoring reports are produced which help the home to develop its practice and ensure that young people are receiving the care and support they need. Regular external monitoring visits take place to provide additional quality assurance. These involve consulting young people wherever possible. The levels of progress young people have made despite their complex needs is a testament to the impact the home has made.

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Leadership and management

The home has a comprehensive development plan for continuing improvement based upon its record of accomplishment, staff training programme and provision of a good physical environment. Records are clear, up to date and stored securely and would contribute significantly to the young people’s understanding of their life in care, if they choose to access these documents. The registered person notifies the appropriate authorities about all significant events relating to the protection of young people accommodated in the home.

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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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