Children's Home run by Crossways Care Ltd in Somerset

Unique reference number SC452009 Inspection date 13/09/2013 Inspector Heather Chaplin Type of inspection Full Provision subtype Children's home

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Date of last inspection 04/10/2012 Website: www.ofsted.gov.uk

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Brief description of the service

This children's home is privately owned. It is registered to provide care and accommodation to one child who may have emotional and behavioural difficulties or learning disabilities.

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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 in this home have made very good progress in terms of their health, diet, development, emotional resilience and behaviour since their arrival at the home. A social worker said that their young person's 'self - esteem has increased massively since she has been there; the staff have shown such a strong commitment to her and have really invested in her.'

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Overall effectiveness

Young people are consulted daily about their care and needs. This helps to ensure full participation in the life of the home. Care planning is highly personalised and is reviewed constantly in response to changes in risk and improvements in behaviour. This means that young people who arrive with a reputation for certain behaviours can move on from these negative labels and prove that they have progressed.

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Overall effectiveness

Young people are protected by clear boundaries and safety is a high priority in this home. The home has excellent policies and procedures in relation to safeguarding and staff are well trained in safe care practice. There are some minor issues raised within safeguarding that have led to this area being rated adequate rather than good, but the home is already addressing these.

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Overall effectiveness

Leadership and management are strong, effective and responsive. The Registered Manager post is currently vacant, but a new manager has been recruited and is aware of the need to submit an application in the near future. Although there have been some management deficits in recent months, the home has an excellent acting manager in place, who has picked up issues and addressed them. This means that the management of the home has improved steadily over the past few weeks and is now good. Shortfalls found at this inspection, which is the first to be undertaken since registration, are in relation to the use of agency staff and the system of physical intervention used by staff when they have to act alone.

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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) keep under review and where appropriate revise the behaviour management policy and notify HMCI of any revision within 28 days; in particular, review the present practice of allowing individual staff to restrain young people on their own (Regulation 17B (2) (a) and (b)) 31/10/2013

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Reg. Requirement Due date

(2001) ensure that the employment of any such persons on a temporary basis at the children's home will not prevent children from receiving such continuity of care as is reasonable to meet their needs; in particular, continue efforts to recruit sufficient permanent staff to reduce the use of agency staff to a minimum. (Regulation 25 (1) (b)) 15/11/2013

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Outcomes for children and young people

Young people in this home have made very good progress from their starting points in all areas of their lives. They have very complex needs but have begun to develop a more positive self view in response to the high quality care provided. One social worker said that their young person had really low self esteem, but that now, 'she is really proud of her achievements'.

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Outcomes for children and young people

Young people benefit from consistent behaviour management and as a result, there are clear signs of increased stability and improvements in behaviour. This has enabled some young people who were formerly in the home to move to foster placements, which is a good outcome for them.

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Outcomes for children and young people

Young people now enjoy very good health. Their diet, and consequently their behaviour and health in general, have improved considerably since they arrived in the home. They participate fully in menu planning and shopping for their own meals, which also helps to increase their life skills. Young people are developing an understanding of what constitutes a healthy lifestyle. For example, they enjoy football, which increases their fitness and overall health. There are no identified issues with alcohol, smoking or drug misuse and young people do not put themselves at risk by going missing from the home.

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Outcomes for children and young people

Young people have access to a dedicated key worker, but can also speak with any member of staff in the home to express their views and feelings. This ensures that young people can participate in the running of the home and in making decisions about their lives.

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Outcomes for children and young people

Young people attend mainstream school, but were not able to remain in the classroom all day before coming to the home. This meant that they were unable to access the full curriculum and this impacted on what they could achieve. Because young people's behaviour has improved considerably, they can now stay in the classroom throughout the school day. Young people's school attendance has been maintained at a good standard.

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Outcomes for children and young people

Although young people are not interested in joining clubs in the community, they benefit from many constructive and stimulating activities. These include visits to local attractions, walks, picnics, swimming, singing lessons, sports and visiting the company's caravan at a local beach.

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Outcomes for children and young people

Young people experience extremes of very difficult emotions and consequently, they have been involved in a high number of incidents. Although they have needed to be physically restrained on a large number of occasions, the incidence of this is reducing as their behaviour improves. The reduction in physical interventions and improvements in behaviour have led to a plan where staffing can now be reduced gradually, over a period of time. For example, young people can now undertake car journeys with a single member of staff, which is a much more normal way of life than having two staff present at all times. This is a positive outcome and shows how much good progress young people have made in the home.

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Outcomes for children and young people

Some young people have complicated contact arrangements in place, but they are helped to enjoy positive supervised involvement with family members as appropriate and in line with their care plans. Young people have their phone calls monitored for their own protection.

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Outcomes for children and young people

Young people in this home are very young. However, they are already enjoying cooking with staff, preparing meals and shopping for foods and other household items.

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Quality of care

Staff and young people have warm and positive relationships, which have been instrumental in bringing about the improvements in outcomes. Staff are extremely dedicated and very child-centred in their approach. Young people are consulted through surveys and house meetings, but benefit from a considerable amount of one to one staff time. This means that they have every opportunity to contribute their views.

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Quality of care

Some young people have raised complaints, which have been investigated. The complaints officer provides good quality feedback to young people and the home learns from any issues raised.

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Quality of care

Highly personalised care is one of the home's key strengths. Care planning is very detailed and comprehensive, with excellent individual strategies. These are regularly reviewed and consequently, young people benefit from a dynamic approach to risk, where they have the opportunity to move on from previous issues. For example, there was an initial risk assessment that stated there would be no pets in the home, due to some young people's history of harming animals. Because good progress has been made, young people have now been allowed to look after a stick insect, under staff supervision, to see how well this is managed. So far, this has been very positive for the young person.

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Quality of care

The home has good strategies in place to support school attendance. For example, if there is an issue with a young person not wishing to attend school, staff do not allow them to remain in bed, they do not provide any unnecessary attention and they do not permit any paid activity. This ensures that non-school attendance is never reinforced. Staff also support young people's progress in school, through educational games and activities.

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Quality of care

Communication between the home and the school is very good. Young people have access to the internet in the home, but this is supervised and only accessible on the home's own computer. Young people are unable to access the home's wifi password to access the internet on their own laptops and tablets. This is for specific safeguarding reasons relating to the young people's care needs.

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Quality of care

Staff ensure that young people's healthcare needs are well met in this home. Medication is kept safely and records are complete and provide an effective audit trail. Young people have access to children and adolescent mental health services and other specialised resources to help meet their needs. A social worker said, 'the staff work well with other agencies such as CAMHS, and take on board their advice'.

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Quality of care

The home is located in a pleasant rural area, with very few close neighbours. There is easy access to large towns, moorland and woodland walks, and to the coast. The home has an attractive garden and is well maintained. There are no obvious health and safety hazards.

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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

This home generally keeps children and young people safe through good care practice and well-defined, robust procedures. Young people's confidence and humour around the staff team demonstrates that they feel comfortable and safe. Young people can talk with any member of staff, but they have key workers who provide regular and constructive guidance, challenge inappropriate behaviour and address any other issues that may impact on young people.

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Safeguarding children and young people

The home has very clear behaviour management strategies. Staff operate through well-defined boundaries, to ensure that young people understand what is and is not appropriate. A previous young person's behaviour improved to the point where she was able to move to foster care, which was a very positive outcome for her.

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Safeguarding children and young people

Due to young people's psychological difficulties and consequently challenging behaviour, there have been assaults on staff, resulting in injury. However, young people's behaviour is well managed, restraint is the very last resort and staff hold key worker sessions to debrief after any incident. All physical interventions have been necessary to avoid injury to young people and staff. Although there have been 31 days since March 2013 when a physical intervention has been used, with a peak of 11 restraints in April, since then, the frequency, intensity and duration of these have all significantly reduced. For example, there were no physical restraints in June. This shows that the behaviour management plan is proving effective in helping to change young people's behaviour. This in turn brings about positive outcomes for young people.

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Safeguarding children and young people

Although the choice of restraint method is up to the service, this method allows single person interventions to control behaviour. In most instances these are undertaken safely and the behaviour is contained. However, in one instance, such a restraint resulted in an accidental fall involving the young person and member of staff. This could have led to serious injury to the young person, although fortunately on this occasion it did not and swift, appropriate action was taken to ensure that they were not harmed.

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Safeguarding children and young people

The home has had to use a number of agency staff since registration. It has tried to keep this to a minimum by using the same agency staff as much as possible. There has been an alleged safeguarding issue involving a member of agency staff and the home has now stopped using this agency. The alleged incident is currently under investigation and has been appropriately referred to the Local Area Designated Officer.

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Safeguarding children and young people

Young people in the home have never gone missing, which is a very good achievement. Staff understand the locally-agreed protocol to be used should this occur. The home has very effective strategies in place to help protect young people if they should go missing in future. The home has very good links with other agencies to help keep children safe.

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Leadership and management

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

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Leadership and management

The home has a vacancy for the Registered Manager's post, but effective interim arrangements have been put in place. The Registered Manager from one of the company's other homes is caretaking this home and a new prospective manager has been appointed from within the company. Discussion took place about the need to submit an application in the near future. The new appointee is said to be well aware of this necessity and she is now undertaking some shifts at this home, in order to allow young people to get to know her.

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Leadership and management

This is the home's first inspection since registration, so there were no requirements and recommendations in place from a previous inspection. However, the home has made good progress since registration in terms of achieving positive outcomes for young people. There is a development plan in place and the home is monitored effectively, both internally and externally. This helps to ensure that the home delivers good quality care for young people, irrespective of their gender and their cultural, religious and ethnic backgrounds.

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Leadership and management

Monitoring includes robust Regulation 33 visits, conducted by an external or senior manager within the company. There was a period prior to the recent change in management arrangements when there were a number of identified deficits in paperwork which were not addressed from one Regulation 33 visit to the next, but these have been addressed since the acting manager came into post in July.

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Leadership and management

The home has a clear Statement of Purpose and is operated accordingly. There is a children's guide which is accessible to young people in different formats, according to their needs. Reviews are held at timely intervals and all local authority documentation is in place to promote effective care planning within the home.

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Leadership and management

The home is simply and pleasantly decorated, clean and well maintained. Young people are able to personalise their rooms to make them more homely and to ensure that they have with them some treasured items to enhance their lives. There is limited contact with neighbours, due to the home's rural location, but there have been no complaints from the local community.

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Leadership and management

There is always sufficient staff to cover all the shifts in the home. Young people are on two-to-one staffing and are progressing to one-to-one staffing at the moment. This is being introduced gradually and in a managed way. However, due to staff sickness and holidays, the company has had to use a number of agency staff since registration. For example, in the last Regulation 34 report, the manager identified that the former manager personally undertook 60 shifts in the home between January and June of this year, in addition to his management responsibilities. This must have impacted on the amount of time the former Registered Manager had available to manage the home. During that period, 59 shifts were covered by agency staff. All other staff in the home covered between nine and 26 shifts each, so the number covered by the manager and by agency staff was disproportionately high.

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Leadership and management

The young people find working with agency staff unsettling, so the home had worked hard to try to keep the number of different individuals involved to a minimum. The company has responded to the staffing situation and has taken steps to recruit more permanent staff. Although the company is not yet fully staffed with its own employees, a number of new staff are completing their induction currently. This will provide continuity for young people and will help to build a strong, cohesive, permanent staff team.

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Leadership and management

Training covers all the areas required in order to ensure that young people are cared for by knowledgeable and skilled staff. Staff are receiving training on the signs and effects of child sexual exploitation and the provider ensures that staff receive information about the latest research to inform their practice. This in turn helps to keep young people safe.

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Leadership and management

Staff receive regular supervision, which is well recorded and effective. Staff also receive annual appraisals to review practice and help identify their training and development needs. This in turn helps to ensure that staff provide a good quality of care to young people.

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Leadership and management

Young people's records are clear and up to date, to help ensure that they and the staff have access to current information about their lives. Records are stored in a confidential environment.

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Leadership and management

The home has very positive relationships with other agencies and with the placing authorities responsible for their young people. This helps to promote a joined-up approach to the care provided, which in turn improves outcomes for young people.

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Leadership and management

The provider handles all notifications to Ofsted and these are submitted in a timely manner. There have been some serious incidents in the home when staff have had to manage young people's behaviour proactively, but they do contain these situations without having to call the police to help them, so they have not resulted in notifications.

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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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