Children's Home run by S P Homes Limited in Lambeth

Unique reference number SC065535 Inspection date 17/07/2013 Inspector Angus Mackay Type of inspection Full Provision subtype Children's home

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Date of last inspection 14/03/2013 Website: www.ofsted.gov.uk

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Brief description of the service

This is a privately-run children's home which caters for up to six young people who have emotional or 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 adequate .

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Overall effectiveness

Young people have very good outcomes, achieved with the support of skilled staff interventions. Young people make progress in self-help skills, communication, social mobility, attendance in education or courses and in reducing high risk behaviours. Staff aid young people to meet their own personal and cultural needs and have excellent relationships with the young people and their families. Staff, and in particular the manager, are described by external professionals as being very stable, calm, very good at communicating, very patient and adopt an approach tailored to each child’s individual presenting problems.

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Overall effectiveness

The manager demonstrates a clear understanding of the shortfalls in the service and has a clear idea of how to move it forward. He has led a significant improvement in the service ensuring that previous requirements and recommendations were successfully addressed. This has resulted in a safer environment and improved outcomes for young people. The environment is mainly warm, welcoming and homely in feel.

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Overall effectiveness

The external monitoring of the home, however, is poor and does not support the manager’s own analysis and development of practice. In addition, despite the good work done with young people and the very good improvements in complex problems, there is little evidence of how results are achieved. Risk assessments, placement plans and behavioural management plans are not properly constructed, reviewed or maintained.

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Overall effectiveness

Other areas for improvement are the development planning of the home, medical permissions, maintenance of all areas of the home and ensuring notifications are made in a timely manner.

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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.

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Reg. Requirement Due date

(2001) maintain in respect of each child who is accommodated in a children’s home a record in permanent form which is kept up to date. This in particular relates to individual support plans, behaviour management plans and risk assessments (Regulation 28) 31/08/2013

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Reg. Requirement Due date

(2001) improve the monitoring of the home. This particularly relates to the quality of the registered provider's monthly reports on the conduct of the home (Regulation 33(4)) 31/08/2013

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Reg. Requirement Due date

(2001) improve the provision for the welfare of children accommodated in the home, particularly in respect of written individual support plans. (Regulation 11(1)(a)) 31/08/2013

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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 children's health is promoted in accordance with their placement plan and staff are clear about their responsibilities and decisions are delegated to them and where consent for medical treatment needs to be obtained (NMS 6.5)  ensure there is a system in place to notify Ofsted within 24 hours of any notifiable events in accordance with Regulation 30 (NMS 24.1)  ensure that the home is well maintained in particular that bedrooms are upgraded (NMS 10.3)  ensure that there are clear and effective procedures for monitoring and controlling the activities of the home, in particular that there is a development plan in place which incorporates the views of the young people (NMS 21.1)  ensure there is a system in place to monitor the quality and adequacy of record keeping and take action when needed. This in particular relates to individual support plans, behaviour management plans and risk assessments. (NMS 21.1)

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Outcomes for children and young people

Young people make considerable progress in all health issues including their mental health. A consultant psychiatrist commented that young people who displayed considerable mental health and behavioural difficulties have made significant progress. Examples provided of progress include drops in the frequency and intensity of challenging behaviour, better community engagement and a reduction in anxiety. For example, anxieties which some young people experience about attending dental appointments are patiently worked through with staff support. This means that all young people receive dental treatment, aiding their improving health. Young people also enjoy good physical health. Staff work closely with young people on diet, providing healthy well balanced and culturally appropriate meals. Young people have access to appropriate quantities of fresh nutritious food. They prepare many meals by themselves and help staff to prepare others. Young people are building a clear

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Outcomes for children and young people

understanding of portion control, food preparation and healthy eating through this process.

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Outcomes for children and young people

Young people make excellent progress with engagement in education and training programmes. Staff work closely with other agencies to attain perfect attendance and improving punctuality. A tutor commented, ‘His attendance is 100% and his timekeeping is gradually improving.’ Young people have clear career ambitions and are working closely with staff in the home and other professionals to achieve them.

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Outcomes for children and young people

Young people with communication difficulties and learning difficulties are making good progress in developing self-confidence and a positive self-view. Staff provide them with opportunities to take responsibility for improving self-help skills, such as going out unaccompanied and purchasing their own clothing. Young people gain immensely from this, in responding to trust, building confidence in the community and successfully negotiating new experiences. Other activities help young people to develop self-help skills, such as doing their own laundry and assisting in managing the home’s food budget. Through these activities young people are acquiring a range of skills necessary in their preparation for independence.

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Outcomes for children and young people

Young people maintain and continue to develop appropriate contact and close relationships with their families. Staff use these experiences to aid young people in maintaining and developing an understanding of their cultural backgrounds. Friendships are encouraged, aiding young people in developing a broader social network and community involvement. Young people engage positively in local sporting clubs improving their health and developing relationships in the local community.

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Quality of care

Placing social workers, family members and other professionals are very positive about the quality of care provided by staff. Relationships between staff and young people are warm and appropriately friendly. Staff structure interactions in a way which assists young people on the autistic spectrum to understand and to be understood.

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Quality of care

Staff work closely with young people, their families and social workers, ensuring they identify and meet all young people's personal and cultural needs. In particular staff aid young people in maintaining and improving family contacts, including families who live abroad. Social workers praise the work done in addressing cultural issues and young people say their needs are all met with staff assistance. A young person said of the staff, ’They make me meals like I would get at home. They look after me well and make me feel safe here. I think I have improved a lot with their help.’ A consultant psychiatrist said of the staff team, ‘They are very helpful, very thoughtful about young people’s needs. They are very conscientious and thorough in how they do their jobs.’

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Quality of care

Staff work proactively with families and other professionals aiding young people to meet the targets in their care plans. In particular, young people who have experienced significant difficulties in the wider community and in educational settings make significant progress. Examples of good progress are successfully learning how to use public transport, consistent attendance at training programmes and positive use of community resources. A professional from a work scheme commented, ‘His attendance here is as a result of a lot of joint work with the home.’ A family member commented, ’They are good at working with the family to jointly impact on his behaviour.’

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Quality of care

Staff have worked diligently to maintain young people in meaningful education or training. Support includes attendance at all meetings and aiding young people to address any problems they experience, for example with time keeping. A social worker commented, ‘He has made good progress with educational attendance, which is down to work done by the home.’

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Quality of care

Staff evidence a clear understanding of the needs of the young people. Staff show an excellent understanding of how to overcome communication difficulties young people have. Young people receive individualised care which is appropriate to their understanding and recognises personal and cultural issues. However, the home’s written placement plans, risk assessments and associated documentation are very basic, poorly maintained and not up to date. There is little detail showing how staff support young people to meet the targets, reduce risk and set new targets. For example, there is no evidence to support the work of staff who successfully reduce the frequency and intensity of physical outbursts of young people.

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Quality of care

Since the last inspection staff have improved the storage, issuing and disposal of medication. Medicines are safely stored in the office and a check of tablets held showed the recording to be correct ensuring the safe care of the young people. However, there are no permissions for medical treatment on file and the placement plans do not clearly evidence how health promotion is met.

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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 with significant behavioural and mental health issues show a reduction in aggression and are learning appropriate ways of raising issues or expressing their frustration. There have been no physical interventions this year and no instances of young people going missing. A social worker commented, ’He had a lot of problems with his behaviour in his two previous placements leading to them breaking down. I have no major complaint with his behaviour now. The home manages it very well. They communicate well with him, which is very important, and they explain things to him in a way he can understand. He had previously been violent, or threatening violence, this is not happening now.’

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Safeguarding children and young people

Staff have a shared understanding of how to work with young people and provide clear communication, good structure and predictable routines for them. Staff at a work project commented, ‘In the past he had difficulties because of communication issues he had. He would resort to aggression and violence. The home has helped him with his communication and he has more coherent conversations now and less aggression.’ However, care plans are poorly maintained and do not reflect the good work done by staff. Risks are not comprehensively identified and risk assessments, care/placement plans and behavioural management plans are not regularly reviewed and updated.

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Safeguarding children and young people

Young people say they feel safe in the home and that staff look after them well. The home has safeguarding policies and procedures which staff apply in their work with young people, enhancing their safe care. Staff receive training from the local safeguarding team ensuring they are knowledgeable about current risks and practice and competent in applying this. Young people benefit from staff application of this knowledge in keeping them safe in the community.

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Safeguarding children and young people

The home has successfully improved the safety of the environment by its comprehensive response to identified fire hazards. All staff have been trained as fire marshals and have practiced the use of fire prevention systems, evacuation of the building and the use of fire fighting equipment. The environment is physically safe and staff universally apply vetting and monitoring of all visitors, enhancing the safe care of young people. Health and safety checks are thorough and responses to identified hazards are prompt. For example, during the inspection a potential trip hazard was rectified.

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Safeguarding children and young people

The home’s application of its comprehensive recruitment and selection policy helps to ensure that only suitable staff are employed. The staff team is suitably diverse and is able to meet the care and cultural needs of the young people accommodated. Staff work closely with young people ensuring they know how to remain safe in the home and how to use the home’s complaints procedure or report any bullying or mistreatment. There have been no complaints from neighbours, young people, their families or social workers since the last inspection. A family member said, ‘I have no problems with the home everything is ok. They look after him well and I think he is safe there.’

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Leadership and management

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

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Leadership and management

The manager of the home is suitably qualified, well experienced and highly respected by staff and young people. The manager has a good understanding of the strengths and weaknesses of the service as evidenced in his analysis of activity in half-yearly reports supplied to Ofsted. The home has a business plan but no development plan which would capture the manager’s clear ideas for the development of the service in line with the current budget.

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Leadership and management

External monitoring of the service is regular but reports are lacking in detail. For example, reports rarely incorporate the views of young people or their families, are not readily available and have failed to identify shortfalls in staff recording systems and timeliness of notifications. Reports do not comment on the excellent work at reducing incidences of young people missing from care, make no comment on staff disciplinary measures and most importantly rarely reflect the comments of the young people. Reports provide no useful information or commentary for the manager to aid his monitoring of practice and improvement of standards of care. In addition, reports are often several months out of date when received by the manager. For example, the most recent report in the home in July was for April.

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Leadership and management

The home is well maintained and has a pleasant family feel. A visiting consultant psychiatrist commented on the home, ’The environment is very welcoming and pleasant. It is always very welcoming, a nice place to be in and if we feel that way young people are likely to feel that way as well.’ The manager indicated that unused bedrooms would have new carpets and furniture before admissions were made but there is no development or maintenance plan for the home evidencing this. Health and safety checks are suitably regular and enhance the safety of young people.

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Leadership and management

Since the last inspection all recommendations and requirements were met. However, the promptness of reporting notifiable events has slipped from 24 hours to two weeks or more. All incidents were reported to the relevant bodies but this time delay inhibits other agencies responding in a timely manner to safeguard young people. Incidents which have occurred were dealt with appropriately by the home including telephone calls to social workers at the time, ensuring that young people’s care was not compromised by this shortfall.

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Leadership and management

Staffing standards are enhanced by regular supervision and annual appraisals. Staff are suitably qualified or are in the process of gaining a suitable level 3 qualification. Recent additional training includes fire marshal training, safeguarding level 1 and 2 and non-violent crisis intervention which ensures staff are appropriately prepared for working with the young people.

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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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