Children's Home run by Friends Therapeutic Community Trust in Cambridgeshire

Unique reference number SC025733 Inspection date 09/10/2013 Inspector Louisa Bayley Type of inspection Full Provision subtype Children's home

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Date of last inspection 26/02/2013 Website: www.ofsted.gov.uk

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

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Brief description of the service

The service is run by a charitable community trust and provides a therapeutic programme and treatment for up to 17 young men with emotional and behavioural difficulties and/or learning disabilities. The service caters for a specific range of needs and ages as detailed in the Statement of Purpose.

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Brief description of the service

There are a number of semi-independent bungalows in the grounds and a separate satellite service for those who require transitional accommodation before living independently. There is a wide range of facilities including on-site education and vocational workshops to support accredited work-based learning courses.

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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 with complex histories and needs benefit from highly individualised and well planned care. Individual programmes consider each young person’s background, characteristics and culture, as well as any barriers to them making progress. The multi-disciplinary staff team use their wealth of skills, knowledge and experience to support young people to overcome obstacles and access a wide range of opportunities. One external professional said the home is ‘as good as it gets’.

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Overall effectiveness

Young people make excellent progress in all areas of their development. This is because of the care they receive, the structured routines and the high aspirations staff have for them.

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Overall effectiveness

Young people have positive views of the staff and of the care they receive. They have realistic expectations of relationships, accepting that some will be more positive than others. However, they all identify staff they can talk to and trust. There is an ethos of openness and honesty and young people say that learning to trust is one of the areas where they feel they have made progress.

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Overall effectiveness

Young people say they feel safe. The routines, levels of supervision, consistent boundaries and management of behaviour underpin their safety. External professionals say staff work hard to support young people to understand risky behaviours and take responsibility for keeping themselves safe.

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Overall effectiveness

Managers have taken action to address the recommendations from the previous inspection. However, this inspection identified a number of regulatory shortfalls including a lack of consultation with parents by the independent visitor, incomplete recording of the use of restraints and consequences, incomplete information in the Statement of Purpose and a failure to submit the revised Statement of Purpose to Ofsted within the required timescales. Some fields are also missing from the records of admissions and discharges. An area for further improvement relates to routinely offering young people an opportunity to be examined by a registered nurse or medical practitioner following an incident of restraint. The shortfalls identified do not directly impact on young people’s outcomes, safety or well-being.

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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) compile in relation to the children’s home a written statement which shall consist of a statement as to the matters listed in Schedule 1 with specific reference to including the number, relevant qualifications and experience of persons working at the children’s home (Regulation 4(1) Schedule 1(5)) 29/11/2013

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Reg. Requirement Due date

(2001) keep under review and, where appropriate, revise the statement of purpose and the children’s home guide and notify HMCI of any such revision within 28 days (Regulation 5(a) and (b)) 29/11/2013

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Reg. Requirement Due date

17B (2001) ensure that within 24 hours of the use of any measure of control, discipline or restraint in a children’s home, a written record is made in a volume kept for the purpose which shall include all matters set out in Regulation 17B (Regulation 17B(3)) 29/11/2013

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Reg. Requirement Due date

(2001) ensure there is a record in the form of a register showing in respect of each child accommodated in a children’s home all matters set out in Schedule 4(1) (Regulation 29(1) Schedule 4(1)) 29/11/2013

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Reg. Requirement Due date

(2001) interview, with their consent and in private, such of the children accommodated there, their parents, relatives and persons working at the home as appears necessary in order to form an opinion of the standard of care in the home. (Regulation 33 (4)(a)) 29/11/2013

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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 where there has been physical restraint, children’s homes must be able to call on medical assistance as required and children are always given the opportunity to be examined by a registered nurse or medical practitioner. (NMS 3.16)

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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 develop a positive self-view as a result of the intensive programmes they complete. By acknowledging their personal histories and behaviours they learn how to process their feelings and gain a powerful insight into the motivations for their actions. As a result, they develop emotional resilience and identify new pathways leading them away from repeating previous behaviours. They also develop excellent understanding of diversity and tolerance, enabling them to accept each other’s unique characteristics.

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Outcomes for children and young people

Young people engage in a wide range of educational opportunities. All young people access education individually tailored in a format that suits their age, stage of development and readiness to learn. They complete recognised, certificated courses and gain skills that will benefit them in later life.

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Outcomes for children and young people

Individuals identify the progress they have made in taking responsibility for their health. Some young people have stopped smoking; others have reduced or eradicated incidents of self-injurious behaviour. External professionals confirm that young people make great improvements in their emotional and psychological well- being. Young people say they access a good range of physical activities and they enjoy a healthy and varied diet. Where young people have issues with their weight, staff support them to take responsibility to achieve their goals through healthy eating and exercise. This further serves to increase individuals’ self-esteem and feelings of self-worth. One professional said of a young person: 'He was in and out of custody and his mental health was poor; I am seeing a very different young person now.'

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Outcomes for children and young people

All of the young people access community activities and leisure opportunities. They welcome members of the local community to the home, for example there is a bonfire night celebration every year which is well attended by local residents. Young people also invite members of the wider community to their annual pantomime production. This gives young people the opportunity to integrate socially with a wide variety of people.

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Outcomes for children and young people

Young people develop independence skills that will benefit them in later life. There is an outstanding independence programme which builds gradually on skills development. Every young person moves at their own pace; their needs and backgrounds are carefully integrated into their independence planning. This highly individual approach recognises those who may need more nurturing, perhaps for example because of having been a young carer previously. The young people say they enjoy learning new skills and talk animatedly about the opportunities they have to move on to higher levels of independence. This enables them to take on additional responsibilities as and when they feel able to do so.

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Outcomes for children and young people

Life skills, such as learning to drive, are embedded in the care provided, enabling young people to access opportunities they would not otherwise be able to.

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Outcomes for children and young people

Where contact with families is appropriate, staff work closely with young people and social workers to facilitate this.

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Quality of care

The quality of the care is outstanding .

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Quality of care

The routines and activities in this home underpin positive and mutually respectful relationships between young people and between young people and staff. The regular community meetings provide a vehicle to express views, challenge unacceptable behaviour and explore feelings. Young people say this is sometimes very difficult but they understand how it supports them to recognise the impact of their behaviour on others. Young people feel comfortable enough to respectfully challenge staff, demonstrating the high levels of trust they have and the sense of security they feel. They are able to express their wishes, feelings and preferences and they say staff listen to them and react positively.

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Quality of care

Staff provide a high quality written guide for young people when they are first admitted to the home. They ensure that young people receive a thorough induction to the home. This is something that young people say they found very helpful. Young people are aware of the complaints process and of external professionals who they can contact. They say they access an advocacy service which they utilise and find very valuable.

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Quality of care

Care plans provide detailed information, supporting staff to provide care on a highly individual basis. Young people are integral to their care planning and are consistently involved in decision-making about their lives. They are able to express their views and affect the way they are cared for. An external professional said: 'I could not commend this home any more, they are fantastic.'

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Quality of care

The staff in the home provide a wealth of knowledge and expertise across all areas of young people’s development. This means young people access the physical, emotional and psychological support they need, when they need it.

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Quality of care

There is an education provision on site delivering a wide range of educational programmes. Young people have education plans and pathway plans and staff develop their own understanding of individuals’ aspirations. This helps individuals to identify courses and subjects that will support them to achieve their potential. Some residential staff work in the educational provision; this further builds on residential staff’s understanding of individual’s attainment levels and potential. Regular meetings between key staff and young people further promote this excellent level of information sharing. Consequently, all staff are able to encourage and develop an individual’s learning.

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Quality of care

There is a wide range of social and leisure opportunities available for young people. These include community-based activities such as playing football against a local team and swimming at a local pool. Young people have been able to experience a residential week on a narrow boat and a week-long holiday. Within the home, they play football, learn mechanics, play pool, play computer games and participate in theatre productions. The range of activities promotes a variety of social skills and practical skills as well as physical fitness and team building. An opportunity of particular note is the week long independence stay in a house in the community. Young people learn how to access information from agencies in the community on issues such as benefits. They visit the job centre, complete job applications and have a taste of what it is like to move on. This provides an excellent insight for young people in preparation for their transitions.

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Quality of care

The staff in this home hold the promotion of equality and diversity as core values. Many of the young people arrive with low self-esteem and feelings of no self-worth. Some have not accessed consistent education, social opportunities or good quality care. Staff work with young people to ensure they are able to recognise barriers that prevent them from accessing their rights and learn how to overcome them. There is a diverse staff team and a diverse group of young people living in the home. They respect each other’s culture and heritage and develop understanding of their needs and differences.

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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 arrive at this home with highly complex, risk-taking behaviours. They are well safeguarded and it is clear that, over a period of time, behaviour which is potentially harmful to themselves or other people is reduced. That is a direct result of the care young people receive and of the time and effort the staff invest in helping young people achieve this.

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Safeguarding children and young people

Young people say they feel safe and this is supported by placing professionals. High staff ratios and robust supervision reduce the potential for bullying and incidents of negative behaviour. Where incidents do occur, staff and young people reflect on them during community meetings. This means individuals can understand the impact they have on others and learn to develop a sense of empathy.

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Safeguarding children and young people

There have been no incidents of unauthorised absence. The use of physical restraint is low. Where restraint has been used it has been proportionate and used only as a last resort. Staff routinely record these incidents. However, the records are incomplete and currently do not meet regulatory requirements. For example, staff do not record young people’s names in full and some records do not reflect the fact that there has been a debrief with the individual concerned. In other cases there is no record of which members of staff were involved. As a result, the records do not always provide a clear and comprehensive account of each and every incident or of the action that was taken. In the absence of a clear audit trail, this has the potential to cause difficulties, particularly if individuals choose to access their records at some point in the future. It is also clear that staff do not consistently offer young people the opportunity to be examined by a

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Safeguarding children and young people

registered nurse or medical practitioner following an incident of restraint, regardless of whether or not they require medical attention.

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Safeguarding children and young people

Staff use consequences as a response to negative behaviours. The consequences are proportionate to the behaviour. However, some records are not complete: they do not include full names and in some cases there is no indication as to whether young people have been spoken to about the consequence. This does not provide a clear picture of events and action taken.

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Safeguarding children and young people

There are comprehensive checks in place to ensure safe recruitment of staff. The checks are recorded and personnel files reflect that the responsible person follows up references and ensures all staff have had relevant police checks. Visitors sign in and staff ask to see identification. This ensures unchecked persons do not have unauthorised access to young people.

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Safeguarding children and young people

The health and safety checks are comprehensive, with good oversight by a well- trained and experienced site manager who has overall responsibility for health and safety. There is a very positive approach towards risk management and the site manager is actively involved in raising young people’s awareness of safety through proactive work and assessing their knowledge of risk. As a result, young people become risk aware, rather than risk averse.

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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

A Registered Manager leads a team of staff who have a wide range of skills and experience in supporting young people with complex needs. The staff team are committed to, and passionate about, ensuring young people achieve their potential. Staff are positive about their roles and knowledgeable about the young people. They have a good awareness of the progress individuals make and the value that living in the home adds to their lives. Staff are supportive of each other. The positive way they talk about their relationships with each other and with young people supports the sense of community.

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Leadership and management

There have been no concerns or complaints since the last inspection. Managers have addressed the recommendations raised at the previous inspection. These included ensuring staff record the effectiveness of consequences, ensuring fire tests are consistently carried out and ensuring placing authorities are advised of all significant incidents. There is a development plan in place which identifies future improvements in the home.

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Leadership and management

The Statement of Purpose provides an accurate reflection of the care and facilities provided by the residential provision. The document gives parents, staff and professionals a clear account of the aims, approaches and ethos of the home. It also sets out the expectations of the home and what young people can expect in terms of their care and proposed outcomes. However, managers have not submitted the latest version to Ofsted. Additionally, the numbers, qualifications and experience of staff are missing from the Statement of Purpose. That is a regulatory shortfall.

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Leadership and management

Managers monitor the records and activities in the home. There is regular oversight from the independent visitor who provides timely and well detailed reports which identify shortfalls. However, the visitor does not consult with parents even when it would be appropriate for them to do so. This means opportunities to gain feedback from parents and carers on the quality of care provided are missed.

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Leadership and management

Staff have regular supervision and say they can access support at any time. They receive good levels of training to support them to meet the needs of the young people. There are good communication systems in place; staff meeting minutes show that there is a focus on young people and on addressing identified issues.

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Leadership and management

Records in the home are stored securely, promoting confidentiality. However, staff are not completing the record of admissions and discharges properly; some fields are missing which means that the records do not provide comprehensive, detailed information.

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Leadership and management

Managers notify the relevant authorities of significant events in a timely manner and with a good level of detail. External professionals confirm they have confidence in the communication from the home when incidents occur.

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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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