Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

Unique reference number SC033268 Inspection date 12/07/2013 Inspector Michelle Bacon / Anthony Kyem Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Date of last inspection 12/02/2013 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 home accommodates up to 12 young people with emotional and behavioural difficulties. It is provided by a private company.

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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 inadequate .

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Overall effectiveness

Overall this service is inadequate despite good outcomes for individual young people. Young people achieve positive outcomes in their education and health while making a positive contribution within the local community. The home is able to demonstrate how young people’s outcomes and life chances have improved overtime. Furthermore, young people achieve placement stability.

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Overall effectiveness

Young people say they can identify members of staff to talk to should they have any worries or concerns. Social workers report they are happy with the care provided. However, there are significant weaknesses in certain aspects of the home that impact on the welfare and safety of the young people. For example, the homes behaviour management policy does not include all aspects of measures of control, restraint and discipline that may be used in the setting. This places children at risk of poor behaviour management practice and possible harm.

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Overall effectiveness

The Registered Manger post is currently vacant as the previous manager has taken up a new post within the organisation. The home is in the process of recruiting a new manager. A head of care was recently appointed and demonstrates a good understanding of the homes weaknesses and action needed to improve the quality of care. A number of requirements and recommendations have been made as a result of this inspection to secure improvement.

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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) ensure no measure of control or discipline which is excessive, unreasonable or contrary to paragraph(2) shall be used at any time on children accommodated in a children's home(Regulation 17(1)) 07/08/2013

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Reg. Requirement Due date

17A (2001) ensure where a measure of restraint is used on a child accommodated in a children's home the measure of restraint must be proportionate, and no more force than is necessary should be used(Regulation 17A(2)(a)(b)) 07/08/2013

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Reg. Requirement Due date

17B (2001) prepare and implement a written policy which set out the measures of control, restraint and discipline which may be used in the children’s home. This relates specifically to use of a practice referred to as the ‘reflection area.’ The policy must also include the means whereby appropriate behaviour is to be promoted. (Regulation 17 B (1) (a) (b)) 07/08/2013

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Reg. Requirement Due date

17B (2001) keep under review and where appropriate revise the behaviour management policy; and notify the HMCI of any revision within 28 days(17B(2)(a)(b)) 07/08/2013

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Reg. Requirement Due date

(2001) ensure that all significant events listed in schedule 5 are notified to the appropriate authorities without delay (Regulation 30 (1)) 07/08/2013

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Reg. Requirement Due date

(2001) ensure there are suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicine received into the children’s home. (Regulation 21) 07/08/2013

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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 the children's views, wishes and feelings are acted upon, in the day to day running of the home and this is reflected in the minutes of the young people's meetings (NMS 1.1)  ensure the home provides a comfortable and homely environment that is well maintained and decorated.(NMS 10.3)

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Outcomes for children and young people

Outcomes for young people are good . From their starting point of placement young people are making good progress in terms of their education, health and emotional resilience. Young people experience placement stability and as a result they feel settled. One placing social worker reported that ‘the social, emotional and behavioural progress′ their young person has made since moving to the home ‘ is quite significant and remarkable.‛

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Outcomes for children and young people

All young people enjoy good health. They benefit from having access to a range of health services including a dentist, doctor and optician. In addition, all young people have access to a specialist psychological service. This supports them to develop some understanding of their background and build emotional resilience.

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Outcomes for children and young people

Young people benefit from the extensive grounds to play in and have recently planted their own vegetables. Furthermore, young people attend youth clubs, street dance and horse-riding which contributes to building their self-esteem and developing their social skills.

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Outcomes for children and young people

Young people attend the provider's own school, which is on the same site as the home. From their starting point of placement young people demonstrate good progress in their education. Communication between the home and school is effective to ensure young people's individual progress and achievements.

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Outcomes for children and young people

Young people's sense of identity is strengthened by contact with their families and those significant to them. Where there are contact restrictions in place, this is clearly recorded in a young person's placement plan. Furthermore, some young people have established positive friendships within the local community.

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Outcomes for children and young people

Young people are provided with the opportunity to develop their independence skills, appropriate to their age and ability. They are encouraged to keep their bedrooms tidy and can help with tasks, such as preparing tea.

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Quality of care

Most young people say they have good relationships with the staff and each other. Social workers report that ‘the standard of care is very good.′ One placing social worker states, ‘all staff have in depth knowledge about each child’s needs. This is due to the excellent placement plans and the monthly in depth progress updates that are shared within the staff team and with the local authority. ’

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Quality of care

Young people views are sought through individual one-to-one sessions and house meetings. This means they have some say in the running of the home. However, it is not clear from the minutes if the young people have had a decision about the requests they have made. This is because the meetings do not start with a look back at the minutes of the previous meeting to ensure actions have been followed up. This means young people may not understand why it may not be possible to act upon their wishes in all cases. The health needs of young people are well promoted. They have access to an on- site school nurse. Staff support young people to attend their medical appointments and to maintain a healthy diet. Staff receive guidance from psychologists who attend regular consultancy meetings with them. This means that young people's emotional well-being is promoted.

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Quality of care

The arrangements for dealing with medication are not robust. Although medication is stored securely, medication record sheets do not clearly record the amount of medication that has been administered to a young person or include the remaining stock balance. This means young people's welfare is not fully protected.

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Quality of care

The home is situated in a rural area with a nearby town easily accessible by car. However, some areas of the home are showing signs of wear and tear, such as the carpets and the dining area. The home has a rolling programme of redecoration in place and further work to upgrade parts of the living areas is planned. Each young person has their own bedroom and they are free to personalise these to their own taste and style. Some young people have pets, such as a gold fish that they can keep in their rooms. This gives young people a sense of belonging.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people report they enjoy living at the home, where they generally feel safe. Staff are vetted and selected carefully to protect young people from unsuitable people. Visitors to the home are chaperoned and there is suitable monitoring of such people.

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Safeguarding children and young people

Staff are trained in child protection so they know how to protect young people from abuse, neglect, bullying and exploitation. Consequently, staff know how to deal with allegations and report suspected abuse. Young people feel safeguarded and benefit from appropriate support and protection. Young people report they can identify individual staff members they can turn to for support if they feel threatened or unsafe. As a result, they have a positive sense of personal safety.

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Safeguarding children and young people

The vast majority of young people report, there are no issues with bullying. Where young people have identified bullying as an issue, they confirm that staff have taken appropriate action, to support and protect them. Young people benefit from the support they need to maintain positive peer relationships and resolve conflicts positively.

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Safeguarding children and young people

Staff take appropriate action to promote young people’s safety, should they go missing. They follow agreed protocols and procedures to promote young people’s safe return. The home has clear practices that support effective action and minimise the incidences and risk of young people going missing. The home’s response towards behaviour management is too controlling with ineffective behaviour management practice. There is an over-reliance on the use of sanctions which are punitive, not proportionate or targeted. The same types of sanctions are used repeatedly. These are ineffective in practice and don’t support the development of young people’s positive behaviour.

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Safeguarding children and young people

The home uses a particular intervention known as the ‘reflection area’. This practice involves young people being encouraged to go to the ‘reflection area’ if they have misbehaved or they need time out to ‘reflect’. Young people say, ‘I get told to sit there, if I’m naughty.’ The reflective practice is not covered appropriately in the home’s behaviour management policy. In the absence of relevant guidance and clear instruction, it is unclear how staff understand, share and implement this approach safely.

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Safeguarding children and young people

There have been occasions where young people have been guided or escorted to the ‘reflection area’ and their behaviour has deteriorated as a result. This involves the use of restraint to get children to comply with staff instruction. In addition, the home encourages young people to have ‘time out’ on a chair if they are naughty. This practice is a potential restriction of liberty. One young person clearly indicated that they were made to spend a set amount of time, on the chair. They implied they had previously been restrained there. This measure is potentially abusive, restrictive and unnecessary and is a breach of the children’s home’s regulations 2011 which say that restraint can only be used to prevent injury, serious damage to property or, in the case of a child accommodated in a secure unit, to prevent absconding.

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Safeguarding children and young people

There are aspects of restraint practice that are judged to be potentially unsafe. The records demonstrate on occasions individual staff members have restrained young people on their own. This leaves staff susceptible to allegations and potentially increases the risk of young people sustaining an injury. Some restraints have resulted in an injury to young people. This has led to one young person making a complaint about the use of restraint. Such interventions are unsafe and potentially damage the relationships between staff and young people.

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Safeguarding children and young people

The home consults with the local authorities designated child protection officer (LADO) so that appropriate action can be taken to protect young people, if needed. Ofsted has not always been informed of all allegations/complaints promptly; in line with home’s statutory responsibilities to report all significant events.

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Safeguarding children and young people

Young people’s records contain an appropriate risk assessment and a placement plan that covers some aspects of behaviour management. However, these do not provide staff with clear instruction and effective intervention strategies to help them manage young people’s behaviours and safely address them. As a result, there is poor and inadequate behaviour management practice.

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Safeguarding children and young people

Young people benefit from a physically safe and appropriately secure living environment. The security and safety of the premises is managed efficiently. All health and safety checks are kept up to date and there is regular maintenance of the home’s fire fighting equipment and fire alarm. Sufficient fire drills are held so young people are familiar with, and know how to follow the home’s emergency fire evacuation procedures. Consequently, they know how to leave the premises quickly and safely.

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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 home has a Statement of Purpose and a ‘what we do and why we do it’ booklet that outlines the aims and objectives of the service. The statement is well written but it does not provide an accurate reflection of staff working at the home or include their individual qualifications, skills or relevant experience. As a result, it does not meet regulations.

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Leadership and management

At this present time the home does not have a permanent Registered Manager. However, interviews to fill the vacant position are reported to be held shortly. The interim management arrangements are considered suitable and provide adequate management cover for the home. Staff benefit from regular supervision and some training provided is appropriate to develop their knowledge and skills in the work they perform.

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Leadership and management

The quality of young people’s care is generally monitored appropriately. There are a range of managerial monitoring activities that are used to review and improve the standard and quality of young people’s care. This enables the service to understand its strengths and weaknesses and take action to secure improvement. The head of care is in the process of introducing new systems to help the home run more smoothly. The management acknowledge there are shortfalls with ineffective behaviour management practice. They have started to address some of the issues they have identified.

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Leadership and management

The home has gone through a period of recent instability. The service is in the process of transition with the appointment of new staff and the vacant position of the Registered Manager. There are sufficient staff currently employed to meet the needs of young people.

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Leadership and management

Outcomes for young people remain positive. The home promotes young people’s positive health, emotional, educational and social well-being. The home is able to demonstrate how young people’s outcomes and life chances have improved over time. The home has a positive track record in enabling young people to return home to their birth families or alternative families successfully.

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Leadership and management

There were no requirements or recommendations for improvement made at the previous inspection. The home has a written development plan in place, which is expiring and is scheduled to be reviewed shortly.

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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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