Children's Home run by 4d Care Ltd in Cambridgeshire

Unique reference number SC064557 Inspection date 11/09/2013 Inspector Stephen Halliley Type of inspection Full Provision subtype Children's home

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Date of last inspection 08/01/2013 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 is privately owned. It is registered to look after a maximum of six young people with emotional and behavioural difficulties. Education facilities are provided by the organisation at a school in the local village.

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Brief description of the service

The home works flexibly to meet the needs of young people's placement plans as identified by local authorities. The home supports young people to achieve positive moves to independence, supported accommodation or alternative placements.

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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 make extremely good progress in all areas of their lives while living in this home. This is founded upon well planned, highly individualised and regularly updated care plans being in place. This helps ensure staff meet young people's individual needs including those related to culture, nationality and religion very well. Young people attend school or college and have made significant steps in their education including passing nationally recognised exams and qualifications, improved literacy and numeracy and transition to mainstream education when deemed appropriate and in the young person's best interest.

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Overall effectiveness

Relationships between young people and staff are very strong and based around an extremely high level of commitment from the staff to provide the highest quality care to young people. This leads young people to speak positively about the staff and about their experiences in the home. Young people are clear that staff listen to them and respond to their wishes and feelings and that this leads to them feeling valued by staff and that they are an integral part of the day to day running of the home.

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Overall effectiveness

Young people and their social workers report that young people are safe in the home and young people clearly state that they feel safe. Risk assessments are regularly updated to ensure young people can take age appropriate, well-managed risk, that the home is safe and that all health and safety checks are undertaken. In particular the way the home addresses fire safety should be seen as excellent practice.

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Overall effectiveness

The Registered Manager is fully aware of the strengths and comparative weaknesses of the home and has a development plan in place to address this.

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Overall effectiveness

Outcomes for young people are extremely strong, the quality of care provided has some outstanding aspects to it and young people are very well safeguarded in the main. Leadership and management of the home is focused and the manager is aware of areas where improvements could potentially be made.

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Overall effectiveness

Shortfalls were noted in respect of the recording of restraints and sanctions and the administration of medication. The registered provider visits have not been carried out on a monthly basis and the Registered Manager has failed to notify Ofsted of a significant event which occurred in the home. Further minor shortfalls were noted in the completion of missing from care records, the clarity of sanctions being given to young people and the monitoring of records kept in 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

17B (2001) ensure that following the use of any measure of control, restraint or discipline a written record is made, in a volume kept for the purpose, which includes the time of the restraint and confirmation the child concerned and the person using the measure have been spoken to about the use of the measure (Reg 17 (B) (3) © (h)) 30/09/2013

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Reg. Requirement Due date

(2001) ensure that any medication prescribed to the child is administered as prescribed and a written record is kept of the administration of any medication to a child (Reg 21 (2) (b) ©) 30/09/2013

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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 column 2 of the table (Regulation 30 (1)) 30/09/2013

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Reg. Requirement Due date

(2001) ensure visits by the registered provider take place at least once a month (Regulation 33 (3)) 31/10/2013

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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 sanctions for behaviour are clear, reasonable and fair and understood by all staff and children (NMS 3.8)  written records kept by the home when a child goes missing detail action taken by staff, the circumstances of the child's return, any reasons given by the child for running away from the home and any action taken in the light of those reasons. This information is shared with the responsible authority and, where appropriate, their parents (NMS 5.10)  ensure the manager regularly monitors in line with regulations all records kept by the home to ensure compliance with the homes policies to identify any concerns about specific incidents and to identify any patterns and trends. This specifically relates to staff recording the time of sanctions and restraints (NMS 21.2)

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Outcomes for children and young people

Outcomes for young people are outstanding .

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Outcomes for children and young people

Young people make excellent progress in all areas of their lives while living in this home. Educationally, socially and in terms of developing independence and a sense of self-esteem and self-worth progress for all young people has been outstanding.

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Outcomes for children and young people

All young people have developed a clear understanding of their backgrounds and why they are living in this home. They are very well supported to look at aspects of their cultural and racial heritage in order to fully understand who they are. Young people show a high level of emotional maturity and this is being supported through individual plans and interventions. This is helping young people to cope in a more appropriate manner when their emotions and anxieties are heightened. Food produced by young people while at school and their willingness to share this with staff and visitors shows a clear confidence in the skills they are developing and this extends to travelling independently, having free time, playing in local sports teams and understanding the plans in place for them moving on. This all serves to enhance young people's self-esteem and self-confidence as they develop and improve on their social and emotional skills base.

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Outcomes for children and young people

Young people have developed a good understanding of their own health needs. This includes taking responsibility for doing physical activities, eating a balanced diet, stopping smoking and planning their own medical appointments. This serves to improve young people's independence skills and ensure they live a healthy lifestyle. Support from staff, regular appointments with a range of health professionals and access to child and adolescent mental health services and a range of therapists ensures all health needs, both physical and psychological, are fully met.

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Outcomes for children and young people

Young people benefit from attending a school run by the home which allows them to re-integrate into education in a small group setting with appropriate staff support. Attendance levels are very high with one social worker commenting their young person 'has done really well with his attendance being 100%.' Education is seen as a very important part of a young person's life by the staff and they support attendance and achievement unfailingly. Young people have achieved good examination results, have maintained college placements and some have successfully transferred to mainstream education. This positive approach to education ensures young people achieve well and can take up college placements or apply for apprenticeships with a good experience and examination results behind them.

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Outcomes for children and young people

Young people contribute to the day to day running of the home in a number of areas; daily chores, tidying rooms, menu, holiday and activity planning and the highly individualised decoration and furnishing of their bedrooms. This ensures young people develop a sense of this being their home and that their involvement in it is valued by staff. Young people are actively involved in charity work including national and international fundraising events such as Comic Relief. Additionally they do lots of work to set up a huge Christmas light display and donations are taken for the church roof in the village and other local charities. This ensures young people are fully aware of and have developed a keen awareness of, the needs of others. This further supports their social and emotional growth into well rounded individuals.

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Outcomes for children and young people

Young people benefit from appropriate contact with their families and friends. Family contact is highly valued by young people and staff and the home work tirelessly to support and facilitate this. This helps ensure young people maintain and, in some cases, enhance their relationships with those people who are important to them.

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Outcomes for children and young people

Young people develop independence skills as appropriate to their individual level of understanding and ability. Ultimately skills developed include shopping, cooking, budgeting and independent travel which should equip them with the life skills to ensure they do well in their adult placements.

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Quality of care

Young people enjoy very positive relationships with staff in this home. Those young people who have lived here for a long period have very strong, secure and stable relationships with staff and these are their key adult relationships. Staff are always available for young people, flexible in their approach and join young people in activities so the enjoyment and sense of achievement can be shared. This has been an extremely important tool in developing some relationships with young people as their previous experiences of adults in their life has been much less positive.

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Quality of care

Young people are clear that their views, thoughts and feelings are important to staff in the day to day running of the home. These are obtained through regular group meetings, individual keyworker sessions and general discussion with staff. This serves to help young people understand their thoughts and views are important to staff and that their input is vital to the provision of high quality care. Care plans and placement plans are very clear and regularly reviewed by young people and staff. Young people are also encouraged to attend reviews and other meetings about their plans to ensure they are fully involved in the decision making process. Social workers carry out regular visits to the home and during these visits they read updated care plans, agree new targets and evidence the progress being made by young people. One social worker commented 'This has been a very positive placement for my young person. The team ensure they are very focused on him and the planning for

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Quality of care

him. The environment is very caring and young person focused and this has enabled him to access education, meaningful activities and develop positive life skills. This has turned his life around from a young man who was offending to one who seems to have taken a very positive approach to life.' This clearly shows the impact that a consistent, child-centred and dedicated staff team have on the outcomes for the young people they work with.

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Quality of care

Young people are clear on how they can make a complaint and that this system is clearly followed through. The Registered Manager has looked into minor issues young people have raised as though these were formal complaints and fed back to them on his findings. This approach ensures young people know their concerns are taken seriously and that managers will respond appropriately to any issues they may raise.

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Quality of care

Young people attend regular appointments with a range of health professionals to ensure their physical health needs are met. When young people are ill staff respond appropriately in terms of primary care and make additional doctors appointments if required. Prescribed and over the counter medication are given to young people and this is recorded in individual medical records. However, on one occasion the home ran out of medication for a period of two days meaning prescribed medication could not be given to a young person. Additionally records of the administration of medication on a camping trip are incomplete so it is not possible to ascertain if all medication was given in line with the prescription. Young people have access to child and adolescent mental health services and this is supplemented by individualised therapy programmes with play therapists, art therapists and other professionals as required. This ensures young people's health needs are very well met the vast

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Quality of care

Young people attend a local school which is run by the organisation responsible for running this children's home. This allows for extremely close links between the care and educational staff which ensures a consistent approach to young people and a very well joined up 24 hour learning experience where activities in the home support academic learning. Staff support young people in education on a 1:1 level if needed and this ensures they engage and achieve each day. Staff give education a very high priority and work diligently and consistently to ensure young people attend school. Notable successes are a range of GCSE examinations being passed by young people, successful placements at local colleges and transfers to mainstream education. This ensures young people achieve well in education which will allow them greater access to college or work placements in the future.

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Quality of care

Young people are offered a wide range of activities on a daily basis. Activities observed include going to the gym, football, using the skate park, games consoles and dvds. Other activities young people report they have experienced include camping holidays, bowling, cinema, swimming, iron man challenge, hill walking, cycling and badminton. This range of activities allows young people to develop and practice new skills, develops as sense of individual achievement and also encourages young people to experience working as part of a team with adults and other young people, a new experience for many.

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Quality of care

While the day to day care provided is of the highest order and would, ordinarily, be seen as an example of outstanding practice the issues around the administration and recording of medication have had a significant impact on this area of the inspection.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people report they feel safe in this home, social workers confirm this and good work is done by staff to ensure young people are indeed safe.

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Safeguarding children and young people

A wide range of health and safety checks are carried out regularly, risk assessments, both individual, generic and activity based are regularly updated and the home presents as a safe environment for young people to live. The recording and carrying out of detailed fire safety checks are an area of excellence. The home made a very rapid response to address issues raised in a recent fire safety audit. The fire safety officer commented that they were 'very impressed with the way the home is being run and the way that fire protection in general is treated as very important'. This ensures that the home can be confident that young people will be as safe as possible should there be a fire in the home.

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Safeguarding children and young people

Young people do not go missing from this home with any great regularity. There have been 11 incidents since the last inspection. This included a peak of six incidents in July but there has been only one since this time. This indicates that work being done with young people when they return from absences is having an impact and they are thinking more about their behaviours and responding to situations in a more appropriate manner. Records made are clear and concise though the report for the most recent incident has not been fully completed. The home has a generic protocol in place with the local police to ensure a prompt and consistent approach to young people should they go missing from the home. There are clear systems in place for drawing up highly individualised protocols should any young person become a persistent absconder which will further support rigorous interventions to address this behaviour.

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Safeguarding children and young people

There have been 18 physical restraints of young people since the last inspection. Notably there have only been four incidents since the end of June indicating a significant reduction in the need for staff to use restraint. This clearly shows that early interventions and de-escalation techniques being used are being responded to by young people as they learn to better self-regulate their behaviour. Each of these is clearly recorded though in one case the time of the restraint is not recorded. Some records are not clear as to whether young people have been spoken to following the restraint other than to check if medical attention is needed. Additionally a number of records do not indicate that staff were spoken to following their involvement in the restraint.

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Safeguarding children and young people

There have been 49 sanctions given since the last inspection and young people are spoken with to ensure they understand why these were given and how they relate to their behaviour. However some records appear to show multiple sanctions. This was questioned by one young person who accepted the explanation given by staff and agreed the sanction in place was acceptable to the behaviour. However it is clear there is a lack of clarity in the recording of some sanctions and how these relate to the behaviours they are being given for. Additionally several of the sanction records do not record the time of the behaviour which led to the sanction being given.

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Safeguarding children and young people

Staff who work in the home are subject to a robust series of pre-employment checks and vetting. The recommendation made at the previous inspection in regard to this system has been fully addressed. The visitors book is also used consistently, visitors are appropriately escorted and the home have carried out their own checks on the handy man they use. This ensures young people are well protected from the possibility of harm or abuse by people working with them or who visit the home.

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Safeguarding children and young people

There has been one incident which could have developed into a child protection issue but this has been rigorously investigated and social workers have been informed throughout. The incident has been dealt with in a low key manner as there are no concerns from any professional about inappropriate sexualised behaviour or harm to any young person who was involved. The fact the home looked into this quickly and kept the local authority informed throughout shows they are prepared to deal with instances of potential abuse or harm strongly. In discussion with staff it is very clear they have an in depth awareness of their roles and responsibilities should they have concerns or should an allegation or disclosure be made to them. This ensures they would respond appropriately to young people and they would be kept safe from further harm while the incident is looked into.

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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

This home is well managed by an experienced and knowledgeable Registered Manager. It is clear he has very good relationships with the young people living in the home and the staff who value his leadership, support and guidance.

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Leadership and management

Since the last inspection the Registered Manager and his team have fully addressed the two requirements and the one recommendation which were made. Other progress includes the introduction of a new compliments and complaints book in which all professionals are asked to comment following visits to the home. This gives the manager an understanding of how the home is viewed by visiting professionals and allows for immediate actions to be taken if any concerns or issues are raised. The home are actively involved with local police in setting up a forum so young people can be fully involved in discussions and be made aware of how the Police will work with them to keep them safe if they go missing from the home. Additionally a programme of redecoration is underway which has so far included new windows in all young people's rooms and the staff office, a new office door and some general repair and maintenance work. This helps ensure the home is warm and secure and

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Leadership and management

shows young people that their comfort and safety are important.

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Leadership and management

The Statement of Purpose has been recently updated as too has the children's guide. These are comprehensive documents fully explaining how the home runs. They have been beneficial in helping social workers agree this is the right home for their young people and in helping young people understand their new environment.

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Leadership and management

Managers have initiated a new quality assurance system designed to make sure that monitoring of the home is rigorous and ensure the home meets and surpasses all national minimum standards and regulations. This has been in place since July and the major improvement is the much more detailed recording of the Registered Individual's discussions and consultations with parents and placing authorities. This will allow for a better rounded overview of the service and quality of care to be obtained and responded to. Visits by the independent visitor in line with Regulation 33 have been missed on two occasions. On one of these he contacted a number of social workers in lieu of the visit but this is not acceptable as these visits must be carried out at least once a month.

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Leadership and management

The Registered Manager is clear about the strengths and weaknesses of the home and his staff team. Strengths include the quality, commitment and diversity of the staff team. He also cites their willingness to do a wide range of activities from cycle trips to week long expeditions with young people which help build the character and teamwork of young people and seriously impacts on improved relationships between staff and young people. Perceived weaknesses include a failure to fully detail all work undertaken in written records which he says 'means we do not appear to be as good as I believe we are.' He also believes being a stand alone home could also been seen as a weakness as, potentially, well trained, high quality staff could leave as there is little scope for professional progression in this service.

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Leadership and management

The home employs enough staff to allow young people to benefit from a 1:1 staffing ratio the majority of the time. These staff benefit from regular team meetings, detailed daily and weekly handovers to ensure continuity of care, regular supervision and clinical support from an external provider aimed at improving their understanding of issues such as conflict cycles and attachment theory. This will help them to work with young people in a more structured and consistent manner designed to support young people address and move on from previous experiences. All staff receive mandatory training in areas including safeguarding, behaviour management, fire safety, first aid and food hygiene. Several staff are professionally qualified and those who are not are undertaking or registering to complete the Children and Young Peoples Workforce Diploma upon completion of their induction. This ensures all staff are appropriately trained and qualified to provide a consistent,

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Leadership and management

No notifications of significant events have been received from this home. In discussion with the Registered Manager he is fully aware when notifications should be made and was able to explain why some incidents had not met the threshold for notification. However, following one incident of physical restraint the police were called to the home and a young person arrested. This incident has not been notified to Ofsted as required which may impact on Ofsted, as a regulator, being able to maintain an overview of what is happening in the home.

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Leadership and management

Records held on young people's files are clear, concise and factual. This will help young people have a clear understanding of their life in the home should they choose to look at their files at any point in the future. All files are stored confidentially in the office and cannot be accessed by anyone who does not have permission to do so. There have been no formal complaints received from young people though two issues have been raised with the Registered Manager by a young person. He was clear he did not wish to make this formal complaints but they have been looked into to see if there is any basis for the concerns being raised. This shows a clear willingness to examine practice, learn from experiences and improve the quality of service provided.

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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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