Children's Home run by Hillcrest Children‟s Services (2) Limited in Telford and Wrekin

Unique reference number SC398377 Inspection date 02/12/2013 Inspector Julian Parker Type of inspection Full Provision subtype Children's home

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Date of last inspection 25/02/2013 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

This private home is registered to provide care and accommodation for up to three young people with emotional and behavioural difficulties.

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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

Shortfalls in the planning and admission process to the home for emergency placements have compromised how the home helps some young people sustain progress across various aspects of their lives. The Registered Manager and his motivated staff team strive to promote improved outcomes for all young people in their care. However, the homes progress is undermined when placements are made in haste and without full consultation and involvement in the placement planning process by the home’s manager.

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Overall effectiveness

The staff team are well trained and have sufficient experience to meet most diverse needs of individual young people. However, some reactive placement decisions have not comprehensively confirmed staff training levels as being sufficient to meet the complex needs and challenging behaviour of some young people as displayed in previous placement.

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Overall effectiveness

The absence of representation from the home in the planning of new placements means that a comprehensive evaluation of the suitability of the placement and staff skills required to meet a young person’s needs is not completed. This means that the manager and staff team are necessarily reactive rather than proactive in the provision of care.

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Overall effectiveness

Existing residents are actively involved in developing their placement and pathway plans to ensure they are fully involved about any decisions that may affect them. As a consequence these young people are more confident in sharing their views and opinions. Young people feel listened to, valued and say they feel safe at the home.

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that the children's home is at all times conducted in a manner which is consistent with its Statement of Purpose. This specifically relates to the home complying fully with pre admission procedures (Regulation 4 (6)) 24/01/2014

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Reg. Requirement Due date

(2001) ensure that the HMCI is informed of any revision to the Statement Of Purpose for the home within 28 days of the revision (Regulation 5(b)) 24/01/2014

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Reg. Requirement Due date

(2001) ensure that the children's home is conducted so as to promote and make proper provision for the welfare of children accommodated there. This specifically relates to ensuring at the point of placement that the home can meet the needs of the young person and that their placement is compatible and will not disrupt the stability of young people already placed (Regulation 11 (1) (a)) 24/01/2014

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Reg. Requirement Due date

(2001) ensure that there is at all times, having regard to the need to safeguard and promote health and welfare of the children accommodated in the home, a sufficient number of suitably, competent and experienced persons working at the children's home (Regulation 25 (1) (b)) 10/01/2014

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Reg. Requirement Due date

(2001) ensure that all staff receive appropriate training. This specifically relates to training in managing self-harming behaviour (Regulation 27 (4)(a)) 10/01/2014

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Reg. Requirement Due date

17A (2001) ensure that all staff receive appropriate training. This specifically relates to training in measures of restraint to prevent injury to any person (including the child who is being restrained) (Regulation 17A (1)(a)) 10/01/2014

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Reg. Requirement Due date

(2001) ensure that the registered person promotes the educational achievement of children accommodated in a children's home; in particular, by ensuring that the children make use of educational facilities. This specifically relates to ensuring that young people who are out of education are provided with the resources to continue to study and have a plan to return to education (Regulation 18 (1) (a)) 17/01/2014

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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 reg 33 visits are submitted to the regulator within the timescales prescribed by Ofsted guidance. NMS 21.7 / Ofsted Conducting Guidance para 18.

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Outcomes for children and young people

Outcomes for young people are inadequate .

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Outcomes for children and young people

Some longer term resident young people have made and sustained meaningful attachments with the staff team who care for them. Trusting relationships have formed, helping these young people develop confidence in most aspects of their lives. This stable base helps them consider their future and prepare for independence. Some young people enjoy friendships with other peers in the local community and sustain close personal relationships, supporting their emotional well- being and resilience within social interactions.

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Outcomes for children and young people

All young people confidently express their wishes, opinions and feelings to staff although this communication becomes occasionally compromised by irresponsible random acts such as going absent from the home without permission. Staff react to this behaviour by quickly, contentiously and effectively responding to return young people to the home. They reassure and provide young people with guidance to re- establish socially acceptable routines and in doing so reinforce that young people are really cared for and valued.

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Outcomes for children and young people

Given their starting points, some young people have made and continue to make progress by attending further education placements to experience different career options. For other young people the home has inherited shortfalls associated with how young people’s school placements have drifted, prior to admission. This means that for some young people disrupted school placements and unclear education plans compromise their potential for academic achievement.

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Outcomes for children and young people

Some young people above compulsory school age, who choose part-time further education as a part of their plan, receive assistance for their imminent move to semi- independence with support from their placing authority. With guidance they are largely able to manage their own finances, go food shopping and cook for themselves. Young people have developed the necessary practical skills to take care of themselves in preparation for independent adult life.

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Outcomes for children and young people

Staff accept young people for who they are and are non-judgemental in their practice. This acceptance promotes an understanding of individual heritage, culture and identity. Where appropriate, young people maintain contact with their families and area of origin. Some young people have sustained and strengthened their relationships with people who are important to them and receive staff support in maintaining these personal relationships. This helps support young people’s emotional health and maintain connections with family and area of origin.

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Quality of care

Staff and young people usually share positive and constructive relationships with each other however these are tested when there are unpredicted changes to the home’s dynamic through events such as emergency admissions. The use of individualised positive behaviour management strategies practically assists in supporting young people to manage conflict.

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Quality of care

The temporary utilisation and relocation of staff from other units has provided young people with some familiar faces and support when moved from other units. This type of individual support is not always effective in encouraging young people to establish themselves in their new placement but does replicate tried measures of intervention when young people’s anxieties heighten. As a result, potential conflict situations such as self-harming behaviour for example head banging, can de-escalate and young people encouraged to –take control of their behaviour.

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Quality of care

Young people say that they know how to make a complaint. There are low levels of complaints as staff and young people positively address most issues informally. Young people’s views, wishes and feelings significantly influence the day-to-day running of the home. Staff regularly seek young people’s feedback through daily discussions, young people’s meetings and key worker sessions. Detailed key working records confirm that important, personal and sensitive topics get discussed regularly with young people. As a result young people can concentrate on the matters important to them and influence their placement plan.

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Quality of care

For established young people living in the home, comprehensively detailed and up- to-date care and pathway plans outline how the placement will meet specific needs and focus on clear measurable outcomes. Staff and young people regularly review these plans and reflect upon the progress made. For one emergency admission, plans are in place but lack sufficient detail to confirm that this is the particular, named, home of choice. This decision has been determined through a matching of placement to complex behavioural needs, without completing a thorough impact risk assessment. In practice the home has provided a consistent quality of care and placement stability that has proven to be effective in significantly reducing former levels of challenging and deliberate self-harming behaviour.

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Quality of care

The Registered Manager and staff team prioritise the value of young people’s education as a key component of their care plan. Wherever needed the home representatives attend and contribute to young people’s educational reviews and are proactive and consistent in supporting young people’s attendance and achievement, irrespective of the level of their education placement. Where necessary staff from the home provide direct support to young people in their respective education settings to promote inclusion and support positive outcomes. Where young people have unclear plans about their education future, for example with emergency admissions, the home’s manager is assertive in producing plans to re-establish school engagement either in mainstream or by using the organisation’s own provision. Staff work closely and effectively with other professionals including the provider’s psychotherapy team, who contribute to team meetings. Staff share and explore

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Quality of care

young people’s specific needs and receive therapeutic guidance and strategies on how support for young people may be provided. This input helps shape highly personalised care and support packages for young people. As a result, young people’s psychological, emotional and social development improves.

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Quality of care

Staff adopt a non-judgemental approach and effectively discuss and promote equality and diversity within the home. Young people receive care from both positive male and female staff role models helping their understanding and acceptance of individual differences. Staff positively address the needs relating to young people’s cultural background and personal identity, in both daily living and care planning. Young people benefit from visiting places of personal interest and exploring their cultural background.

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Quality of care

The home is appropriately located to meet the individual and safety needs of young people. Continued improvements to the décor and fabric of the building have enhanced the physical environment since the last inspection. Works to the grounds are on-going but do not adversely impact on the quality of the provision. Young people are encouraged to personalise their own space and happily contribute ideas to enhance the good overall presentation of the children’s home.

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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

For some established young people the staff team have sustained good progress by successfully recognising the triggers associated with young people’s behaviour. As a result, the frequency of young people going missing from care, or challenging staff in other ways has reduced over time. By providing consistent boundaries that young people find firm and fair, implemented in the home’s structured environment the staff team promote a sense of safety and well-being for some young people. Young people say that they feel safe and freely able to share with staff any concerns about their safety. They have not had to make any complaints about the quality of the provision.

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Safeguarding children and young people

Standard practice in the home involves staff producing and following comprehensive individual risk assessments to promote with young people their safety, both in the home and in the wider community. Behaviour management and placement plans identify specific risks and their likelihood. In some circumstances young people are enabled to safely encounter proportionate risks, as part of their growth and development.

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Safeguarding children and young people

The use of physical restraint within the home has, until recently been rarely used and only as a last resort to prevent injury to people, self-injury or serious damage to property. Its use has increased slightly as a result of placement change. Staff continue to collate accurate records and sensitively support young people to reflect and comment upon any incidents requiring the use of physical restraint.

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Safeguarding children and young people

An emergency admission to the home has made a significant impact to the home’s previous level of stability, temporarily creating some short-term disruption. While establishing routines to provide safe staff support this process has exposed shortfalls in the home’s stated policies and procedures. For example the process of assessing whether the placement was suitable before the placement was agreed did not fully involve key staff from the home, nor did it fully assess the potential impact of the transfer on existing settled young people, consider the adequacy of existing staffing levels or their specific level of training and competency for dealing with the specific behaviours being presented. These factors potentially compromise the safety of young people, staff and misrepresent the homes function as described by the Statement of Purpose.

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Safeguarding children and young people

In practice, the Registered Manager and staff team place a robust focus on keeping young people safe, immediate measures have been put into place that ensure behaviour is managed sensitively within explicit boundaries. By providing high levels of nurturing staff support, keeping young people fully involved in care planning and meaningfully occupied, the manager and staff team have successfully intervened to dramatically reduce the levels of concerning behaviour. These efforts have improved the safety and well-being of young people and reduced the interventions from external agencies such as the police and Child and Adolescent Mental Health Service. The manager has, within a very short time frame, retrospectively addressed the concerns associated with this emergency admission to ensure that his team continue to provide safe and nurturing care.

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Safeguarding children and young people

Some young people do occasionally go missing from the home. The missing from home protocol in place follows detailed risk assessments for each young person and confirms notification made to all relevant professionals and agencies when such events occur. By taking seriously the impact of this behaviour and the potential risk to each young person the home has significantly reduced the frequency of this behaviour. By forming good working relationships with parents and identifying the particular circumstances when young people are likely to go missing from home the home can respond more effectively. The support of the local Community Support Police Officer informs young people of the risks and pitfalls of this behaviour. Comprehensive records confirm that appropriate action is always taken to return the young person to the home safely. Young people’s safety is improved through the caring and rigorous approach taken by the staff team when managing unauthorised

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Safeguarding children and young people

Staff recruitment and vetting procedures follow safe recruitment guidelines operated centrally, that helps to prevent unsuitable people being employed. The home fully implements extensive health and safety procedures, including regular inspections of fire equipment, supporting records and related staff training. Any identified shortfalls receive prompt attention to ensure the environment remains safe.

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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

A qualified and experienced Registered Manager supported by a committed staff team provide the home with the required consistency and stability to offer young people support and security in their placement. Care staff aim to deliver an exceptional quality of care for young people that enables positive outcomes to be achieved. However this aim is compromised when emergency admissions are made without full consultation and administrative procedures being followed ahead of the placement being made. The ‘can do’ approach and willingness of the staff team nevertheless ensures that these procedural matters have a minimal impact on the practical quality of care provided.

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Leadership and management

Quality assurance systems which include consultation with external stakeholders, such as placing authorities, along with meaningful contributions from young people, staff and relevant others informs the managers day-to-day practice. Additionally it shapes the home’s realistic and illustrated development plan. This enables stakeholders to recognise improvement and progress. Placing authority social workers comment very positively about working as partners with the home to progress their young people’s placement plans.

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Leadership and management

The home's operation, function and staffing numbers are accurately stated by the regularly revised Statement of Purpose document. This document has not however, been made available to the regulator following its update and amendment.

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Leadership and management

The placement experience of young people has been consistently maintained through notable staff commitment. This practice reinforces young people’s trust in their carer’s and promotes placement stability. Temporarily measures such as assigning extra staffing to work alongside the home’s core staffing complement to ‘support’ young people moving between homes has not proven as effective as anticipated. This exercise has revealed some differences of approach between homes, for example with particular parts of the methodology used to physically restrain young people. These differences in practice can inevitably create further confusion for young people already experiencing placement difficulties.

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Leadership and management

Staff have access to the provider’s policies, procedures and guidance enabling care practice to be developed. The absence of strict adherence to policies by senior managers making placement decisions has compromised how the home fully evidences its regulatory compliance.

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Leadership and management

Staff training opportunities are available to further enhance individual personal development positively that can contribute to the overall competence and tenacity of the home when dealing with a broad range of emotional and behaviour difficulty. However, not all of the existing staff team benefit from specific training, particularly in the areas of children self-harming, that is desirable to underpin confident safe practice. The home’s manager has been assertive and thorough in quickly addressing these shortfalls. Management records and staff feedback confirm that regular supervision and annual appraisal of individual performance effectively supports staff practice.

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Leadership and management

Young people’s personal records are stored securely and kept confidential. For young people joining the home in a planned manner they cover all matters required by the regulations, inform safe staff practice and confirm how young people will receive the help and support necessary. The home places importance upon ensuring all individual records are up to date recognising the intrinsic value of staff properly communicating important child-related information.

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Leadership and management

The home benefits from monthly monitoring visits by an independent person. These have not always been forwarded to the regulator within the prescribed timescale to confirm that the home is operating effectively and within the remit of its Statement of Purpose. The manager undertakes monthly in-house quality control monitoring that is shared with the regulator six monthly. This means that record monitoring and audit trails confirm how the manager has addressed potential and emerging concerns.

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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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