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

Unique reference number SC033268 Inspection date 11/09/2013 Inspector Gillian Walters / Lynn O'Driscoll Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Date of last inspection 12/07/2013 Website: www.ofsted.gov.uk

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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 adequate .

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Overall effectiveness

Young people are settled in their placements and benefit from highly individual care plans that take account of their individual needs and talents. Young people's plans are successful in guiding their care and promoting positive outcomes in all areas of their development. The home is able to demonstrate the progress and positive achievements of young people placed and chart the success they have experienced in moving children on to permanent homes.

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Overall effectiveness

Young people’s views are regularly sought enabling them to comment on the care they receive. Young people can identify members of staff they can speak to should they have any concerns. Young people are encouraged to have contact with the home’s independent visitor, providing them with an alternative person they can raise issues with.

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Overall effectiveness

Young people benefit from living in a nurturing environment. Young people demonstrate affection towards care staff and have developed very trusting relationships. As a result young people say they feel safe in this home and are happy to be there.

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Overall effectiveness

The home has recently appointed a new manager who intends to make application to Ofsted to become the home’s Registered Manager. The head of care demonstrates a good understanding of the home and the action required to further develop and improve the service. As a result of this inspection three requirements have been made. These relate to improving the timeliness of young people receiving health checks following restraint, the timeliness of staff supervision and appraisal and maintenance of the home. Two further recommendations have been made to address training of those staff supervising contact and the importance of fire drills when a young person is admitted.

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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 within 24 hours of the use of any measure of control, restraint or discipline, a written record is made that includes a description of any injury to the child concerned or any other person and any medical treatment administered. This relates specifically to encouraging children to accept the opportunity of a medical check soon after any restraint (Regulation 17B(3)(g)) 23/10/2013

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Reg. Requirement Due date

(2001) ensure that all persons employed receive appropriate training, supervision and appraisal. This relates specifically to the timeliness of supervision and appraisal in accordance with the home's agreed policy (Regulation 27(4)(a)) 23/10/2013

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Reg. Requirement Due date

(2001) ensure that all parts of the children's home used by children are kept in good structural repair externally and internally. (Regulation 31(2)(d)) 23/10/2013

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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 staff have appropriate training, supervision and support if they are required to supervise and facilitate contact (NMS 9.2)  ensure that there is an emergency escape plan that all staff and children are familiar with and have practised so they know what to do in an emergency. This relates specifically to children newly admitted to the home having early opportunity to participate in an evacuation drill. (NMS 10.9)

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Outcomes for children and young people

Young people are making consistently good progress in their placements. Young people are encouraged to participate in a wide variety of activities and their achievements are recognised. Young people benefit from consistent encouragement and praise provided by staff. As a result many have positive self-image and demonstrate good self-esteem. One young person commented, ‘I am a very good swimmer and diver, I can hold my breath a long time.' Another said, ‘I’m good on the new computer.’

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Outcomes for children and young people

Young people have excellent attendance at the provider’s school, situated on site and are making good progress in relation to their starting points. Young people are able to talk positively about their achievements in school and value the education they are receiving. Young people have positively benefited from the links the school has forged with local mainstream schools that has resulted in some young people participating in a visual arts project enabling them to exhibit their work in a local arts centre. Some other young people have benefited from the opportunity of working with other schools to teach and promote dance. These initiatives have proved positive in building young people’s confidence and self-esteem.

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Outcomes for children and young people

Young people enjoy helping out within the home. For example, setting the tables at mealtimes and helping tidy away afterwards. Young people also actively enjoy participating in events in their wider community, fundraising for local charities and taking part in sponsored events. Young people enjoy knowing they are helping others, feel that their contribution is valued and have fun in the process. One young person commented, ‘I enjoy working at the animal rescue centre with the cats.’

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Outcomes for children and young people

Most young people have a good knowledge and understanding of their background that enables them to have a good sense of their own personal identity. Most young people benefit from contact with immediate or extended family members, ensuring that they maintain links with those that are important to them.

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Quality of care

Most young people say that they have good relationships with staff and each other. One young person said, ‘I like the care staff and most of the other children, but some wind me up.’ Staff show appropriate affection and patience with young people and are sensitive to their need for affection and attention. As a result, young people enjoy trusting relationships with staff and have made some strong attachments within the staff team. Social workers describe children to have ‘very good relationships with staff.’ One independent reviewing officer said, ‘I like the fact that the staff clearly know the children and remain very child-focused in the review meetings.’

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Quality of care

Young people benefit from regular house meetings and individual house tutor sessions. These provide young people with good opportunity to express their views and wishes and enable them to have some say in the running of the home. Recent meetings indicate that young people are being given feedback on issues they raise; this helps them to understand what may or may not be achievable. Young people benefit from comprehensive individual placement plans that take good account of all key aspects of their developmental needs. A social worker commented positively, ‘Their placement plans are one area that stands out.’ Young people’s health care needs are well prioritised and promoted. They have good access to all routine health care services and have the support of the organisation’s school nurse to oversee and co-ordinate their health care planning. The organisation employs the support of independent therapists to provide direct support to young people and

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Quality of care

additional guidance and support to staff. The staff team also benefit from the organisation’s arrangement with a qualified psychologist providing commissioned training and regular support and guidance. These arrangements ensure that young people’s emotional and psychological needs are well understood and promoted. Medication is safely stored and administered within the home. Recent changes made to administration records have improved the quality of recording, promoting safe practice.

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Quality of care

Young people confirm that they know how to complain if they are unhappy or concerned about something. They are able to identify members of staff that they can speak to and share any worries. This means that young people have trust that they will be listened to and know that their views are important.

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Quality of care

Young people enjoy the wide variety of activities that the home can offer. One young person said, ‘I like swimming, dancing, rugby, football, and volleyball.’ Young people also benefit from the considerable grounds surrounding the home. They provide excellent space for young people to enjoy a variety of ball games, play out and ride their scooters. The range of activities available ensures that young people have good opportunity to socialise with their peers, learn new skills, develop their talents and take part in regular exercise.

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Quality of care

The home is situated in a quiet rural location relatively close to the local town centre and all its shops and amenities. The home is an older building that is generally well maintained and decorated and suitable to the needs of the young people. However, during this inspection it was noted that some areas of repair and maintenance had not been identified for action. This included mould underneath a shower seal used by young people and a broken paving slab outside the home that was deemed to be a trip hazard and of danger to young people playing outside.

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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 report to feeling happy and safe in this home. One young person confirmed, ‘I feel safe and happy now’, having described his initial general anxieties about coming to the home. Staff receive regular child protection training, ensuring that they know how to protect young people from abuse, neglect, bullying and exploitation. Staff are familiar with local child protection procedures and how to deal with any allegations or concerns they may have of suspected abuse. Bullying is not identified by young people as an issue of concern at this time. Young people rarely go missing from this home. Young people are well supervised and supported on a daily basis minimising the opportunities for young people to leave the site without authority or staff support. Staff are familiar with the agreed local protocol and procedures to be followed should such an event occur. This ensures that they are well prepared to act quickly and appropriately to locate the

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Safeguarding children and young people

young person and facilitate their safe return to the home.

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Safeguarding children and young people

Following recent enforcement action taken by Ofsted, the home has acknowledged and accepted recent concerns about managing behaviour highlighted in a compliance notice. The home has implemented staff training, to develop staff knowledge and skill in behaviour management. It has also increased management oversight of all activity to ensure greater scrutiny of practice to guide and direct change. Young people have been encouraged to participate in work revising the use of sanctions and rewards. This work along with regular management oversight has created a shift in sanctions now being deemed more proportionate and fair. It has also provided managers with an opportunity to guide staff to achieve more consistent and positive practice.

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Safeguarding children and young people

The home’s revised behaviour management policy provides clear guidance to staff on the acceptable use of sanctions and those that are deemed both appropriate and inappropriate. Staff have benefited from further training concerning the use of sanctions to ensure that they are appropriately and effectively used. Young people benefit from individual behaviour management plans that have been recently reviewed and revised. These provide staff with clear detail about potential triggers and appropriate management strategies that are known to be effective in safely addressing and promoting positive behaviour.

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Safeguarding children and young people

Staff benefit from regular training in behaviour management techniques having two internal trainers available to offer additional guidance and support between formal training events. The home has identified a recent decrease in the use of restraint and taken action to audit and evaluate available data. This has already enabled managers to identify some trends and patterns, providing a positive opportunity to explore further possibilities to reduce the incidence of restraint. The home has made progress in improving the quality of records maintained when restraints occur. However, it was noted that on a small number of occasions following a restraint that the health check was not consistently carried out immediately after the event or within 24 hours. Although young people did not suffer or complain of any injuries on these occasions, delay in carrying out the check was not consistent with safe practice

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Safeguarding children and young people

Young people benefit from living in an environment that is physically safe and secure. Appropriate arrangements are in place to ensure that all visitors are checked before entering the property and that all staff working in the home are vetted and deemed suitable to work with young people. This ensures that they are not made more vulnerable by adults who may do them harm. The home has arrangements in place to regularly check and maintain its fire fighting equipment and utilities. Regular fire evacuation drills are arranged, both day and night to ensure that young people know and have practised how to escape the home in the event of a real emergency. However, it was noted that a fire evacuation drill had not taken place to include a young person recently admitted to the home. Although the large majority of young people are familiar with the escape route and have practised safe evacuation, the safety of one young person in the event of an emergency is less certain.

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Safeguarding children and young people

Placing authorities have expressed satisfaction with the home’s safeguarding arrangements. A social worker said of the home, ’They are excellent at safeguarding children.’

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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 Provider has made a recent internal appointment to the vacant manager position and is aware that manager is required to make application to Ofsted to become the home’s Registered Manager. The new manager is in the process of completing his induction and is receiving additional support from the organisation’s Head of Care. This suitably strengthens management arrangements to achieve a successful transition and drive forward identified plans for improvement.

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Leadership and management

At the last full inspection on 12 July 2013, the home was judged inadequate overall, despite good outcomes for young people. A compliance notice was served along with a number of requirements and recommendations were made as a result of this inspection and a further unannounced visit on 8 August 2013. The compliance notice and all requirements and recommendations have been acted upon during the time since the last inspection and a number of improvements have been identified.

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Leadership and management

Physical interventions and sanctions imposed over the period have been reasonable and proportionate. Records maintained in relation to physical interventions and sanctions demonstrate some improvements in recording and confirm greater management oversight of the effectiveness of methods or restraint and discipline used. The home has reviewed and updated its behaviour management policy and guidance and also their safeguarding policy and procedure. This means staff are much clearer about their responsibilities and the home’s expectations for improving safeguarding practice and the quality of care provided to young people. The provider has arrangements established to keep all documents under review, ensuring that they remain comprehensive and consistent with current good practice and the legal framework.

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Leadership and management

The home has revised and updated its Statement of Purpose to suitably clarify the qualifications and experience of staff working with young people. The home has re- issued guidance to staff and revised arrangements to ensure that all significant events are reported to the appropriate authorities without delay. Arrangements for the handling and administration of medication have been reviewed and revisions have been appropriately made to medication administration records maintained, ensuring that current safe practice is promoted. Deficits previously identified in recording and taking action on complaints have been addressed. This demonstrates to young people that their concerns and complaints are taken seriously and will be acted upon.

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Leadership and management

Staff have benefited from some recent training opportunities to develop their knowledge and skills specifically in promoting positive behaviour that will enable young people to achieve improved outcomes. The home’s development plan identifies further focused training opportunities for staff to address acknowledged weaknesses in staff learning and development. However, staff have not benefited from specific training to support their work in supervising and facilitating contact and this was noted as a shortfall in the home’s staff development planning.

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Leadership and management

Staff generally benefit from regular supervision and annual appraisal ensuring they receive good support in their role. However, during this inspection it was found that a significant number of staff had not been provided with recent supervision, contrary to the home’s policy. Additionally, some staff were late in receiving their annual appraisal. This means that valuable opportunities have been missed in further supporting and developing the workforce.

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Leadership and management

The provider has strengthened monitoring arrangements within the home. Additional monitoring activities have been implemented to audit the quality of care and evaluate available information. This positively assists individual planning and the identification of trends and patterns that contributes to promoting improved practice.

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Leadership and management

The home is adequately resourced and employs sufficient staff to meet the needs of the young people placed. Placing authorities speak positively about the progress made with young people they have placed and their satisfaction with current safeguarding arrangements. A social worker confirmed, ‘They work very well with the placing authority.’

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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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