Children's Home run by Plus One South West Ltd in Somerset

Unique reference number SC467115 Inspection date 12/11/2013 Inspector Janice Hawtin Type of inspection Full Provision subtype Children's home

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Date of last inspection 27/08/2013 Website: www.ofsted.gov.uk

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Brief description of the service

The home which is operated by a locally-based private company, provides care and accommodation for up to two young people who may have emotional or behavioural difficulties. The provider also operates other homes in this area and education can be arranged using other private care organisations who provide small specialist schools.

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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

This children’s home was registered in June 2013. It provides a replacement for another home within the same organisation. The recently appointed Registered Manager, staff and young people moved from that home to this in a planned and considered way to avoid disruption to the young people involved.

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Overall effectiveness

The home provides a sound quality of care, and for the most part young people benefit from relationships with the staff team which are predictable and attentive. The staff are aware of particular vulnerabilities relating to young people. They understand how recent changes in both the environment and in the resident group, alongside some health changes, have impacted on behaviour.

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Overall effectiveness

Two recent incidents resulted in a young person not feeling safe in the home. Although action was taken to protect the young person, the placing authority brought forward a move of placement to avoid any further issues. Another young person is clear they want to stay in the home. Some young people have made significant progress in many areas; others make very slow progress. A social worker confirmed that a young person’s placement in this home’ is appropriate and meeting their needs’, adding that they are ‘experiencing the necessary support and continuity that has been missing from their lives for long periods of time’.

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Overall effectiveness

The home demonstrates particular strengths in engaging young people in education. As a result, attendance has improved. One young person continues to attend from a background of non-attendance and disruption, another young person recently improved attendance by more than 50% following placement in this home, and was able to complete essential course work.

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Overall effectiveness

Staff continue to provide outreach support to young adults who have moved on from the home. Consequently, they can access the help they need to live independently and problems are more likely to be dealt with quickly to avoid crisis.

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Overall effectiveness

The development plan demonstrates some understanding of the strengths and weaknesses of the home so that improvements can be made.

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Overall effectiveness

The manager and staff are supported by a comprehensive policy and recording documents to inform staff and maintain the quality of care. While in many cases appropriate action has been taken in line with these policies, records have not been kept up-to-date or created to support and monitor effectiveness and allow for review. Consequently restriction and monitoring of young people may continue longer than necessary. This has potential to compromise young people’s rights and/or privacy.

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Overall effectiveness

Risk assessments have not been updated following incidents and do not support all current practice. Sanctions records for one young person are not comprehensive. Furthermore, some sanctions are disproportionate and it is not possible to determine their effectiveness.

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Overall effectiveness

Other shortfalls resulting in recommendations include: appraisals for staff, access to a computer with internet access to support young people‘s communication and education opportunities, and keeping memorabilia for young people so that they have a record of their time in the home.

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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 that where only one member of staff is on duty at any time, a risk assessment has been carried out and recording in writing. This should be updated following any increase in risk and identify any risks to children, staff and members of the public (NMS 17.9)  ensure that sanctions for behaviour are clear, reasonable and fair and are understood by all staff and young people (NMS 3.8)  ensure records are clear and up to date (NMS 22)  ensure that physical restrictions on normal movement within the home are not used unless this is necessary to safeguard children and promote their welfare and development. Such measures are only used where agreed with the responsible authority and, if appropriate, the parents. Such restrictions for one young person do not impose similar restrictions on other young people (NMS 10.4)  ensure where electronic devices are used to monitor young people there is a policy which sets out how they should be used , how they promote the welfare of

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Recommendations

young people, how young people will be informed of their use and how legitimate privacy of young people will be protected (NMS 10.5)  promote and provide appropriate forms of contact, in particular provide internet access for young people to support the maintenance and development of family contacts and friendships (NMS 9.1)  ensure that all staff have their performance individually appraised at least annually and that this appraisal takes into account any views of the young people the service is providing for (NMS 19.6)  support and encourage young people to keep appropriate memorabilia of their time in care. Staff record and help young people make a record of significant life events. (NMS 22.6)

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Outcomes for children and young people

Outcomes for young people are adequate .

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Outcomes for children and young people

Young people are helped to understand why they are looked after through understanding of their background and contact with family where appropriate. The staff work in partnership with those important to young people, supporting and facilitating contact where necessary.

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Outcomes for children and young people

A wide and varied range of leisure activities are offered to young people and they currently enjoy fishing, playing tennis, and visiting areas of interest and museums. It has proved difficult to engage young people in attending clubs or community groups which may enhance their social networks and allow them to make more friends in the local area. Staff continue to address this issue, exploring options and encouraging young people to attend. Young people enjoyed an activity holiday during the summer break, where they were able to try out new things and acquire physical and dexterous skills.

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Outcomes for children and young people

Young people are encouraged to share their wishes views and feelings both as individuals, through key work sessions, and in the day-to-day discussions taking place. Views and wishes are routinely sought in decisions around menus and leisure activities. Young people choose their own clothing and toiletries. They are actively involved in personalising their bedrooms and have influenced the purchase of games equipment and an additional television for the home. This practice helps young people to feel valued and contributes to raising self-esteem and confidence.

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Outcomes for children and young people

Good health is encouraged; all young people are urged to attend routine health appointments and are registered with local services. Getting young people to attend the dentist has mixed results with some refusing and others successfully engaging. Young people’s smoking habits are beginning to reduce and specialist services have been sourced to aid this process. However, they continue to smoke on occasion which could affect their physical health into adult life.

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Outcomes for children and young people

Mental health and emotional well-being services are made available to young people as needed. Young people's resilience and emotional well-being is being promoted and a clinical psychiatrist visits the home on a weekly basis to provided help to young people and staff in dealing with presenting issues. Discussions with and assessments by supporting health professionals allows for focused interventions and increases the potential for improving emotional health and well-being. The emotional health of young people and presenting behaviours remain both fragile and difficult. Some progress is discernible and a social worker reported that incidents of very dangerous behaviour have reduced and a young person’s attention span has increase which allows them to contribute to meetings they were previously unable to attend for more than a few minutes. Other young people have remained vulnerable to feeling unsafe and self-harming.

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Outcomes for children and young people

Work done with young people, and the success of engaging them in education helps to prepare them for independence. Through the perseverance of staff and work in consultation with schools young people have continued to improve their school attendance. This has allowed for some to catch up on school work and take exams. The positive involvement of other young people in education is helping them to develop both practical and academic skills. A new planning and evidence document has been produced and printed to ensure records of independence skills are kept. This will also provide a focus for planning and measure preparation for future independence work.

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Quality of care

The home is spacious and has large grounds where young people can play ball games and spend time outdoors. There are two large lounges so that young people have some privacy and space to entertain family and friends. Each has their own bedroom which is decorated to a high standard with furniture, décor and fittings chosen by young people.

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Quality of care

Young people’s interactions and relationships with others are variable and can be both positive and destructive. Relationships are sometimes complicated by unpredictable behavioural difficulties and young people’s inability to deal with change. Each young person has a keyworker of their choice; they feel they can speak to most of the staff to raise any concerns and express their views and feelings. The provision of care is usually on a one-to-one basis which allows for individual needs to be met. Young people are encouraged to participate in meetings and there is evidence that they have influenced development planning, such as the purchase of leisure equipment and suggesting décor for the home.

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Quality of care

The children’s guide to the home is comprehensive and provides detail in a format which is child friendly and easy to understand. Young people know how to make a complaint. Several options are available to them including detail of independent agencies that provided support for looked after children. Young people also have regular access to the Head of Care, responsible individual and placing social workers, so that they can express concerns.

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Quality of care

Arrangements for dealing with medication are safe, administration records are clear and up-to-date and the storage of medication is secure. Consequently, young people receive the medication they require and room for error is minimised.

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Quality of care

Young people are supported to attend education; they are transported to and from school by staff. The staff work in close partnership with providers so that an early resolution can be sought around any issues that may reduce attendance or achievement. Although not without difficulties, young people’s attendance and attainment at school is sustained or has improved dramatically. Young people do not have access to the internet in the home. This reduces opportunities for contact with friends and family and access to the wealth of information available to support education and learning. In addition, chances to address internet safety with young people are reduced.

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Quality of care

Services to improve the emotional and psychological health of young people are readily available. Access to CAMHS is available and the organisation’s clinical psychologist provides assessment of need and guidance for staff alongside individual sessions for young people. This promotes their emotional development and well- being.

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Quality of care

The home does not have a camera on site to take photographs of young people to mark events and achievements. The collection of memorabilia and photographs of and on behalf of young people is insufficient to provide a history of their time in the home which they can keep when they move on.

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Quality of care

Young people are looked after in line with placing authority expectation as indicated in care plans and confirmed by a social worker.

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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

The particular vulnerabilities of young people are known to the staff team. Action is taken to address these and keep young people safe. Staff know what to do should any child protection issues arise and can demonstrate that they would act effectively to safeguard the young people. The home accommodates young people who are both vulnerable and who display extremes of behaviour. Recently, the unpredictable behaviour of one young person led to another feeling unsafe. Staffing responded to this, taking it very seriously and introducing additional staff; however, the young person continued to feel unsafe and a planned move to foster carers was brought forward.

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Safeguarding children and young people

The home has agreements with the local police which support appropriate action when a young person goes missing. Staff are aware of and understand the factors which may trigger young people to go missing. They provide individual support sessions to address and discuss this. They also work in partnership with other agencies to reduce incidents and are pro-active in getting to know the friends of young people and where to actively search for young people when they go missing to return them quickly.

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Safeguarding children and young people

Staff are trained in de-escalation methods to manage behaviour. The use of physical restraint in this home is minimal and only used to protect young people from harming themselves or others. The avoidance of these intrusive techniques protects young people’s dignity. The use of sanctions is balanced with opportunities for gaining rewards. However, not all sanctions are proportionate or recorded in detail so that their effectiveness can be monitored. Therefore, it is not possible to evidence that the best possible opportunities for improving unacceptable behaviour are in place.

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Safeguarding children and young people

Young people benefit from an environment that is physically safe and secure. Regular health and safety checks are carried out by staff. For instance, fire detection systems are evident throughout the building. Young people and staff practice fire drills so that they know how to get out quickly in the event of a fire.

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Safeguarding children and young people

Internal locks on doors are used at night to restrict normal movement within the home. This practice is not subject to risk assessment and review which could lead to an unnecessarily institutionalised environment and distracts from what is otherwise a well maintained and decorated home. Night time electronic monitoring of young people is also in use and was initially introduced to safeguard young people but has not been subject to risk assessment. If used indiscriminately this practice could compromise young people’s right to privacy and dignity.

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Safeguarding children and young people

Young people are protected from having contact with inappropriate visitors. Visitors to the home are asked for identification and a record of their time on the premises is kept.

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Safeguarding children and young people

The summary of recruitment records demonstrate a safe and effective process which avoids inappropriate adults working with vulnerable young people.

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Leadership and management

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

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Leadership and management

The Registered Manager is recently appointed to this post; staff report that he is approachable and supportive. There have been many recent changes to the service including a move of the home to a new area, changes to staffing and more recently a change to the resident group. Managers acknowledged the potential for difficulties during these times and planned change to help smooth transitions for young people.

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Leadership and management

The Statement of Purpose offers clear and comprehensive information for both parents and placing authorities.

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Leadership and management

Training opportunities for staff are robust, with staff able to access training as required. All staff have a minimum level 3 child care qualification which supports competence in their work practice. Working in partnership with other agencies and professionals has allowed staff to receive additional training and support in dealing with mental health and well-being. Support for staff is provided in several ways including team meetings, supervision and access to discussions with the head of care. Detail of staff appraisals and personal development plans are not known to the manager or stored in the home. This misses an opportunity to promote and assess progress which improves the care provided to young people.

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Leadership and management

Not all records are kept up-to-date to reflect current practice, or comprehensive in providing guidance to staff alongside reflective practice opportunities. This includes sanctions records which lack detail of effectiveness and feedback from young people, and risk assessments which have not been updated in response to incidents and to reflect current practice. Other records are appropriate and contribute to understanding young people lives. All records are stored securely to avoid breach of confidentiality.

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Leadership and management

The home employs a sufficient number of staff to care for the needs of young people and additional staff are available in response to need or increased risk. This practice protects both young people and staff.

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Leadership and management

The home was registered in June and first used in September of this year; as such the number of quality assurance reports completed by an individual who is not in day to day charge of the home is limited. Within the wider organisation the format for these has improve to include discussion with young people, staff and other stakeholders in private. The reports are less descriptive and more analytical which offers better information for quality assurance purposes. The manager completes monthly monitoring of the service including health and safety checks to ensure the environment is physically safe.

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Leadership and management

The manager has reported significant events relating to the protection of children to authorities who need this information; this ensures that independent quality assurance and monitoring is in place to protect young people and keep stakeholders informed.

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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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