Children's Home run by BREAK in Norfolk

Unique reference number SC040191 Inspection date 15/08/2013 Inspector Stephen Halliley Type of inspection Full Provision subtype Children's home

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Date of last inspection 18/02/2013 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

This children's home is owned by a registered charity. The home provides long-term accommodation for up to four young people with emotional and/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 make significant progress in many aspects of their lives while living in this home. This is most clearly seen in the importance placed upon education and the positive approach taken towards behaviour management; young people are challenged appropriately and encouraged to consider ways in which they could have handled situations differently. This puts the onus on them to self-regulate their behaviour which will be a useful skill to carry forward into their adult lives.

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Overall effectiveness

Young people's views are regularly used to inform the quality of care provided, it is clear they feel they are a part of the home and that their input is important to staff. The willingness of staff to listen to and respond to young people has supported the development of some strong relationships; young people talk highly of the staff who work with them.

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Overall effectiveness

Staff input is guided by individualised care and placement plans which are regularly updated and reviewed in partnership with young people. Young people are clear they feel safe in the home and that staff are consistently proactive in ensuring their welfare and safety. This includes ensuring young people’s physical and emotional health needs are met though young people do not fully understand their own needs in this area.

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Overall effectiveness

The Registered Manager and her senior team have a clear knowledge of how the home is functioning and have a clear development plan in place to continue the progress already made. Staff are clear that since being appointed the Registered Manager has made a huge difference to the feel of the home, the morale of staff and the care provided to young people.

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Overall effectiveness

There are some areas of very high quality child care being exhibited by staff, especially in the attitude and the manner of their work and being open and honest with young people. It is clear that meeting young people's needs is the focus of the work undertaken by staff.

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Overall effectiveness

A number of shortfalls were identified including gaps in the recording of sanctions, restraints and the administration of medication. The provision of guidance, support and advice on health and personal care issues appropriate to young people's needs and wishes, with particular reference to young people smoking, is not sufficiently robust or consistent. Additionally the Statement of Purpose fails to explain the range of needs the home intends to meet and notifications of significant events have not always been forwarded to Ofsted without delay. Further minor, though still significant, shortfalls were noted around the robustness of the monitoring systems in use, the actions taken when monitoring identified trends and patterns and the completeness and accuracy of some records made within the home.

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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 there is a written statement of purpose in relation to the children's home which shall consist of a statement as to matters listed in Schedule 1; specifically the range of needs the home is intended to meet (Reg 4 (1) Schedule 8 (c )) 30/09/2013

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, restraint or discipline a written record is made which shall include a clear description of the measure used, the time date and location of the use of the measure and confirmation that the person authorised to make the record has spoken to the person using the measure about the use of the measure (Reg 17 (B) (3) (C) (d) (h)) 31/08/2013

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Reg. Requirement Due date

(2001) ensure each child is provided with guidance, support and advice on health and personal care issues appropriate to his needs and wishes with particular reference to young people smoking (Reg 20 (2) (d)) 30/09/2013

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Reg. Requirement Due date

(2001) ensure that any medication which is prescribed for the child is administered as prescribed (Reg 21 (2) (b)) 31/08/2013

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Reg. Requirement Due date

(2001) ensure that if any of the events listed in column 1 of the table of schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in 31/08/2013 column 2 of the table. (Reg 30 (1))

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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 there is a written record of all medication, treatment or first aid given to children during their placement (NMS 6.15)  ensure the manager regularly monitors in line with regulations all records kept by the home to ensure compliance with the home's policies, to identify any concerns about specific incidents and to identify patterns and trends. Immediate action is taken to address any issues raised by this monitoring; this specifically relates to the monitoring of sanctions and restraints records and gaps in the medication recording (NMS 21.2)  ensure all staff's work is consistent with the regulations, national minimum standards and the homes polices and procedures; this specifically relates to ensuring all areas of restraint recording are completed in line with the homes recording system (NMS 21.3)  ensure that entries in records are legible, clearly expressed, non-stigmatising and distinguish as far as possible between fact, opinion and third party information

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Recommendations

(NMS 22.4)  ensure information about the child is recorded clearly and in a way which will be helpful to the child when they access their files now or in the future. (NMS 22.5)

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Outcomes for children and young people

Outcomes for young people are adequate .

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Outcomes for children and young people

Young people make significant progress in many areas of their lives whilst in this home but in other areas this is not so clearly seen.

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Outcomes for children and young people

Young people make good progress in terms of developing a sense of self-worth and confidence appropriate to their individual abilities. They have a clear understanding of why they are living in the home and the reasons behind this. Young people hold appropriate conversations and express themselves clearly and confidently in discussions and are able to rationalise their thoughts and views well. Emotional resilience and maturity as a whole continue to be areas of development to ensure young people respond appropriately to decisions with which they may not agree.

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Outcomes for children and young people

Young people's health needs are met in terms of seeing health professionals and having access to mental health services. However, there is a lack of evidence of work being done with young people to understand their own health needs, in particular around smoking. Initial work, such as referrals to the stop smoking clinic, has been carried out but this has not been robustly followed up in key working sessions to ensure young people understand the potential impact of smoking on their long term health.

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Outcomes for children and young people

Education is given a high priority by staff in the home and all young people have suitable placements for the coming year to meet their individual need. Staff have worked closely with education providers to ensure this is the case and it is hoped a number of GCSE examinations will be taken next year as a result of this diligent placement matching process. Young people who have benefitted from longer term educational placements are achieving well and parents comment on how pleased they are with this.

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Outcomes for children and young people

Young people contribute positively to the running of the home through involvement in chores, decoration of the home, activity and holiday planning. Within the wider community young people are involved in a range of activities and clubs. This has helped them develop a circle of friends with whom they are happy to spend time and to have visit the home. Young people have been involved in fundraising towards the cost of their holiday in France as this home is run by a registered charity. It is felt this community involvement has made them more aware of the economic situation and more able to understand the needs of other groups they have seen fundraising. This will support their improved social awareness and development as they move towards independence.

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Outcomes for children and young people

Young people benefit from family contact at levels and frequencies appropriate to their individual circumstance. This is fully supported and facilitated by staff. Parents feel that contact levels are good and that the home 'is the right place for my child if they can't be at home with me.’

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Outcomes for children and young people

Young people have long term plans to remain at this home until independence. The opportunities for supporting and progressing to independence have been limited recently due to settling new young people into the home. The systems in place allow for clear, achievable plans to be drawn up ensuring young people develop the skills they will need when they move to adult placements. Young people who have recently moved on are doing well in their new placements though they maintain contact with the home showing they appreciate the support they were given and value the on-going thoughts and opinions of adults they have grown to trust.

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Quality of care

Young people benefit from good relationships with staff who have a clear drive, enthusiasm and desire to provide good quality childcare. Interactions are well- balanced between guidance, support and advice and strenuous efforts are made to ensure young people understand the reasons why decisions are made. This allows difficult situations to be worked through with young people knowing decisions are being made in order to keep them safe. Interactions between young people are generally positive though some antagonism does exist within the group. Staff work diligently to address this at the earliest opportunity. This approach has prevented the situation within the group from escalating and potentially being seen as bullying by young people.

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Quality of care

Young people are actively involved in planning the redecoration of the home ensuring they live in a home in which they feel comfortable. They also work with staff to plan activities, menus and holidays. This participation in the decision making process ensures they know that their views and ideas are important to staff. There is a clear procedure in place for young people to make a complaint should they wish to do so. They are confident that their complaint would be taken seriously, be dealt with quickly and appropriately and that they would be told the outcome of their complaint. This ensures young people live in an environment where they feel confident to raise concerns should they need to do so.

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Quality of care

Young people have individualised, detailed and regularly reviewed care and placement plans. These guide the work of staff to ensure that individual needs are addressed and fully met. Young people are cared for in line with these plans and individual daily living plans reflect this. Young people are actively involved in updating their plans and have a good awareness of the progress they have made. They are also encouraged and supported to attend their review meetings which ensure they are involved in decision making which will affect their future. The home actively chases any overdue review meetings or a prompt rescheduling of cancelled meetings. This ensures that young people's changing needs are addressed in a timely manner.

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Quality of care

Young people's health needs are well met in terms of having regular appointments with a range of health professionals. The home has good links to local child and adolescent mental health services which ensures a prompt response to any referrals made. This ensures young people's physical, emotional and psychological health needs can be fully met. However, procedures for the administration and recording of medication are a concern. Prescribed medication has, on two occasions, been missed due to young people being away from the home or going to bed and staff failing to give it. While these omissions have been checked with NHS direct for any potential impact or concerns the failure to administer medication in line with the prescription is not acceptable. Additionally there are gaps in the recording of the times medication was given and some signatures of the staff who administered the medication.

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Quality of care

Support for educational achievement and attainment is good and the home have worked proactively to find suitable placements for young people. This has included identifying and securing alternative educational provision for young people with a clear view to supporting them to maximise their attendance and achievement.

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Quality of care

Young people enjoy a range of activities and staff try to accommodate new ideas where possible when it is safe and appropriate to do so. This includes day trips to theme parks, going to the beach and the cinema and a week long holiday to France was due following the inspection. Young people were actively involved in last minute preparation for this trip and were clearly looking forward to the experience.

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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 say they feel safe in the home and they are kept safe by the health and safety checks which are carried out, the risk assessments in place and the structures and routines within the home. This includes appropriate staffing levels at all times and support for young people when doing activities outside of the home. A parent commented that 'my child is very happy in the home and they do everything they can to keep him safe. It's absolutely great there.'

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Safeguarding children and young people

A range of comprehensive, detailed generic or individual risk assessments is in place to allow young people to take part in age appropriate activities. Young people state that they feel safe within the home and that bullying is not now an issue. Managers and staff have challenged previous instances of bullying strongly and there are clear policies and guidance in place to help staff address bullying should it arise.

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Safeguarding children and young people

Young people rarely go missing from the home but there is some concern that on one occasion they absented themselves late at night without staff being aware. This has not been repeated but there does not appear to have been a particularly robust response to this in terms of consideration to waking night staff or the possible use of door alarms. One social worker comments that 'absconding was something I was concerned about but they have worked with my young person well and they have provided transport when necessary, keep in contact with her on her mobile and absconding had not been an issue.' The home has a protocol in place with Norfolk Constabulary to guide staff responses when young people go missing. This was updated in June 2013 and includes the fact that officers from the Safer Neighbourhood Team will visit the home at least fortnightly to engage with staff and young people. This is intended to support young people to develop a positive

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Safeguarding children and young people

relationship with the police. It will also allow officers to get to know young people which could be highly important should they go missing.

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Safeguarding children and young people

There have been six restraints since the last inspection indicating that young people, in the main, are able to manage their behaviour without this level of staff intervention. All sanctions and restraints are recorded though there are numerous gaps in this recording. This includes records failing to include the time, date and location of the incident or restraint, a lack of evidence on one occasion that staff had been spoken to following a restraint and failure to complete other cross-referencing notes as required by the home. The method of restraint used is recorded in the narrative about the incident but does not always include the type of restraint being clearly indicated. This is, at times, unclear and confusing and can lead to records being misinterpreted. This will not aid young people to understand what happened during the incidents should they look at their records at some point in the future.

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Safeguarding children and young people

Pre-employment checks are robust and well recorded which ensures young people are protected from the potential of harm or abuse from staff who work with them. The diligent use of the visitor’s book and chaperoning of unchecked contractors provides further protection to young people. There have been no instances of harm or abuse recorded since the last inspection. Staff are very clear how they would respond should this occur. This shows they have understood the key points from their training and ensures they would respond appropriately to young people and keep them safe should an allegation or disclosure be made.

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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 Registered Manager and other senior staff have been in post in this home since November 2012. They inherited a team that was lacking clear leadership and guidance. The Registered Manager has made this a focus of her first year in charge. Staff are very clear that leadership and management is much improved with a very clear focus on the work of the home and supporting the staff team while having very good relationships with young people living in the home. She provides a positive role model for staff and one piece of key working around self-harm provides a template for key working sessions which all staff should aspire to match.

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Leadership and management

The Registered Manager and deputy regularly monitor all aspects of the homes work to evaluate the quality of care being provided. However, there are shortfalls clearly identified in the robustness of monitoring and the actions taken as a result of this monitoring. Recent monitoring of medication records, for example, states that all is correct when clear gaps were readily identified during the inspection. Previous monitoring has highlighted where signatures or times were missing and records have been amended accordingly. However omissions of this type have appeared several times since suggesting that strong enough action was not taken following the shortfalls being identified. This has the clear potential to allow for incomplete records to be kept which would not give a full picture of a young person's life while in the home.

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Leadership and management

The home has met the recommendation made at the last Ofsted inspection in February 2013. Other improvements include focused work with the staff team around the Ofsted grade descriptors and national minimum standards so all staff are aware of exactly how these impact on their work and what they need to do to ensure these are met or surpassed. Positive praise records, rewards charts and records of achievement have all been introduced and are being well used. This ensures staff focus on the positive aspects of young people's behaviour as fully as the negative aspects to give a balanced overview of attitudes, concerns and behaviour management. A redecoration programme for the home is also underway and several communal rooms will be painted while the young people are away on holiday. Young people will also be fully involved in the redecoration of their bedrooms once this current phase is completed. This will ensure young people live in a well decorated

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Leadership and management

and maintained home showing their comfort and right to a high quality living environment are important to staff.

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Leadership and management

The Statement of Purpose has been recently amended and clearly outlines the aims and objectives of the home and the services and facilities it provides. This is known and understood by young people, staff and social workers who currently have young people placed in the home. However, the range of needs that the home is intended to meet has not been included in this latest version. This would not allow placing authorities to know if the home is able to meet the needs of young people they may be considering placing and may lead to young people who would benefit from living in this home being placed elsewhere.

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Leadership and management

Strengths of the home are seen as the much improved communication systems under the new Registered Manager, the strong team ethic, the promotion of an atmosphere where appropriate professional challenge is seen as part of staff development and the teams ability to build good relationships with young people and maintain these through periods of challenging behaviour. An identified area of weakness is the consistency within the team in relation to behaviour management and recording. While the behaviour management aspect appears to be improving the recording is not yet consistent or in line with regulations, national minimum standards or the homes own policies and procedures. A development plan is in place to drive the home forward which includes redecoration including a new kitchen being fitted and securing an appropriate referral to take the home to capacity.

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Leadership and management

The home has a large staff complement including Registered Manager, deputy, senior and five full-time and four part-time support workers. There are also four regular bank staff who cover any gaps in the rota due to leave or sickness. This ensures young people are looked after by a consistent team of staff. All staff receive very regular supervision from the Registered Manager or her deputy. Staff are very clear that they feel supervision and annual appraisals have a very clear role in supporting them to do their jobs to the best of their abilities.

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Leadership and management

All permanent staff have undertaken all mandatory training, fire safety, first aid, behaviour management and child protection. Two staff are currently undertaking the Children and Young Peoples Workforce Diploma while all other staff hold this or an equivalent qualification as a minimum. This ensures staff are well trained to enable them to work with young people in a consistent and safe manner.

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Leadership and management

Comprehensive records are held on young people in individual files which are kept confidentially in the main office. With the exception of records previously mentioned these provide a good overview of a young person's life in the home and would enable them to understand their time living here in a clear and concise manner.

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Leadership and management

There has been one complaint received prior to this inspection and this was dealt with appropriately and in a timely manner with the young person involved being satisfied with the outcome. There have been several notifications of significant events made to Ofsted since the last inspection. These have generally been well managed and clear actions taken following incidents to minimise the possibility of any repetition. However, one notification was overlooked during monitoring and received several months after the incident of bullying it related to. The most recent notification, during the Registered Managers annual leave, was not completed until the issue had been resolved several days after the incident had occurred. It is important these notifications are submitted to Ofsted without delay. This ensures that Ofsted, as a regulator, maintain an up to date overview of what is happening within 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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