–

Unique reference number SC370956 Inspection date 09/01/2014 Inspector Judith Longden / Pete Hylton Type of inspection Full Provision subtype Children's home

p.1

Date of last inspection 13/11/2013 Website: www.ofsted.gov.uk

p.1

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.

p.2

Brief description of the service

The home is privately owned and is registered to provide care for a maximum of four young people with emotional and behavioural difficulties.

p.3

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

p.3

Overall effectiveness

The overall effectiveness is judged to be inadequate .

p.3

Overall effectiveness

Young people achieve some positive outcomes as a result of living in this home. All young people are in education and making some progress in their educational achievement. They are also learning independence skills to prepare for adult life. However the quality of care is inadequate in a number of areas. These include the maintenance of the home, competence and knowledge of the staff to address health issues and a lack of support in attending education.

p.3

Overall effectiveness

Staff, including the Registered Manager, are not sufficiently trained in areas such safeguarding, fire safety and medication and therefore young people are not adequately safeguarded. There is an extensive reliance on agency staff that are not subject to safe recruitment procedures and are not trained in areas such as self- harm. This places young people at risk.

p.3

Overall effectiveness

In addition, there are shortfalls in the monitoring of the home by the manager and a lack of consultation with young people. This does not therefore provide a sufficient overview of the quality of care provided. The manager has failed to address two previous compliance notices from the last inspection and an additional six breaches of regulation have been identified as a result of this inspection. In addition there is one failure to meet national minimum standards in relation to the home's response to the views of young people.

p.3

Overall effectiveness

However, the majority of young people say they feel safe and cared for and generally enjoy sound relationships with staff and each other.

p.3

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.

p.4

Reg. Requirement Due date

(2001) ensure the registered provider and the registered manager shall, having regard to the size of the children's home, its statement of purpose, and the number and needs (including any needs arising from any disability) of the children accommodated there, carry on or manage the home (as the case may be) with sufficient care, competence and skill (Regulation 9 (1)) * 28/02/2014

p.4

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 relates to ensuring any use of agency staff does not prevent continuity of care and that any agency staff employed by the home have relevant self-harm training. Also that recording of health matters is consistent and accurate. (Regulation 11 (1) (a) (b)) * 28/02/2014

p.4

Reg. Requirement Due date

(2001) ensure the routine of the home is organised so as to further children's participation in education, including regular attendance at school and participation in school activities of children of compulsory school age, regular attendance at college where applicable (Regulation 18 (1)(b)) 28/02/2014

p.4

Reg. Requirement Due date

(2001) ensure full and satisfactory information is available in relation to any person who works in the home who in the course of his duties has regular contact with children accommodated there in respect of each of the matters specified in Schedule 2. This specifically relates to agency staff (Regulation 26 (3)(d)) 28/02/2014

p.4

Reg. Requirement Due date

(2001) ensure that all persons employed by the registered person receive appropriate training, supervision and appraisal (Regulation 27 (4)(a)) 28/02/2014

p.4

Reg. Requirement Due date

(2001) ensure that all parts of the children's home used by children are kept clean and reasonably decorated and maintained (Regulation 31 (2) (e) ) * 28/02/2014

p.4

Reg. Requirement Due date

(2001) establish and maintain a system for improving the quality of care provided in the children's home (Regulation 34 (1)(b)) 28/02/2014

p.4

Reg. Requirement Due date

(2001) ensure the system referred to in paragraph (1) shall provide for consultation with children accommodated in the home, their parents and placing authorities. (Regulation 34 (3)) 28/02/2014

p.4

Reg. Requirement Due date

*These requirements are subject to a compliance notice

p.4

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.5

Recommendations

 ensure children know that their views, wishes and feelings are taken into account in all aspects of their care; are helped to understand why it may not be possible to act upon their wishes in all cases; and know how to obtain support and make a complaint. (NMS 1)

p.5

Outcomes for children and young people

Outcomes for young people are adequate .

p.5

Outcomes for children and young people

Young people make sound progress in achieving positive outcomes especially in education and learning skills for independence. Young people are able to identify the progress they have made, one said, 'the home has really changed me for the better.' This helps improve their confidence and self-esteem.

p.5

Outcomes for children and young people

Young people generally enjoy reasonable health, although some continue to engage in risk taking behaviours and self-harm. Menu planning is of good quality, and young people benefit from a healthy, balanced diet. Exercise is encouraged through activities such as the gym in order to promote healthy living. Some young people continue to smoke although they have discussed ways to stop and understand the risks associated with smoking.

p.5

Outcomes for children and young people

Young people enjoy a range of activities in the community and also enjoy relaxing at home and watching television. Young people participate in activities such as pamper nights which provide an enjoyable experience as well as promoting self-esteem. Young people also benefit from appropriate contact arrangements with their parents, family and friends. Arrangements are clearly recorded and contact is facilitated to ensure young people enjoy their contact and remain safe.

p.5

Outcomes for children and young people

Young people's attendance at school and educational achievement is generally good given their starting points. They attend various educational placements that are suitable for their individual needs. As a result young people are achieving their educational potential.

p.5

Outcomes for children and young people

Young people undertake some activities in the home to develop basic practical and life skills such as cooking, laundry and cleaning and arranging interviews and appointments. This means young people receive adequate care which helps them prepare for adulthood.

p.5

Quality of care

Young people live in a home that continues to be poorly maintained. Previous inspections have identified a number of shortfalls in this area and a compliance notice was issued at the last inspection. This has not been met and further issues of poor maintenance and décor have been identified as a result of this inspection. The manager has taken some action to address the shortfalls but there remain a number of issues that impact on the quality of the environment for young people. In addition, there are examples of poor cleanliness in the home such as overflowing bins, dirty bathrooms and food debris left on plates in rooms. This does not provide a welcoming or hygienic place for young people to live.

p.5

Quality of care

Young people say they can talk about their care in key work sessions and at house meetings. They also know how to make a complaint. However, some young people say key work is not regular enough and also say they do not feel their views are always taken seriously. As a result young people do not adequately influence their care or the running of the home.

p.6

Quality of care

Staff have recently completed training on self-injurious behaviour to improve their competence in meeting the complex needs of young people. However, the home relies on the deployment of a number of agency staff and the use of agency staff has increased since the last inspection. The agency staff who work in this home do not have adequate self-harm or self-injurious behaviour training to support the young people. This issue has previously been subject to a compliance notice and remains a significant shortfall in the quality of care for young people. As a result, the needs of some young people are not sufficiently met by staff employed in this home.

p.6

Quality of care

Young people's care plans and behaviour management plans are of a reasonable standard and are updated to reflect incidents. However, some reports prepared for reviews do not contain the most recent information. For example, one report stated that self-harm had decreased and was insignificant in nature. However there had been a recent incident where the young person had been taken to hospital claiming they had sniffed lighter fluid. This means the information regarding young people is inconsistent and does not provide an accurate account of their needs or the care provided.

p.6

Quality of care

Young people say they enjoy good relationships with staff and generally get on well with each other. Their behaviour in the home and community is also good. One young person stated the staff care for them and keep them safe. They said their only issue was the remote environment and stated, 'if I could pick the home up and move it somewhere else that would be good.'

p.6

Quality of care

Young people have access to a range of medical professionals including mental health specialists, opticians and dentists. Staff encourage young people to identify their health needs and how best to meet these. However, action is not always taken by staff to ensure these needs are met. For example, one young person said they wished to stop smoking and a number of incentives and methods were discussed with the young person but no further action was taken to progress this. Other young people have been supported to stop smoking, even for short periods as part of a nationwide scheme to encourage people to reduce their smoking. This has enabled young people to enjoy a period of time where they have not smoked and has helped them understand the benefits of stopping or reducing their smoking. Some staff are trained in the administration of medication but a number of staff, including the manager, have not received this training. This means the administration of

p.6

Quality of care

medication is not always completed by trained staff. Recording of the administration of medication is accurate; however the audit of medication records is often carried out by the manager which does not promote safe practice.

p.7

Quality of care

Young people attend a variety of educational placements. Some of these involve travelling long distances and because of insufficient public transport links the young people often rely on staff to transport them to education. There have been several occasions where young people have not attended because the cars have been out of use due to brake failure and flat tyres. The manager has not taken swift action to rectify these issues and this has resulted in young people missing school. In addition, appointments are often made during school time which necessitates the young person staying at home and missing their education. This means the home does not provide a routine that supports young people's educational attendance.

p.7

Quality of care

Young people are encouraged to take part in activities within the community such as youth club and a drama group. This encourages them to socialise as well as developing skills and enjoying new experiences.

p.7

Safeguarding children and young people

The service is inadequate at keeping children and young people safe and feeling safe.

p.7

Safeguarding children and young people

The home has a number of policies and procedures for safeguarding practices in respect of child protection and handling allegations. The quality of recording of allegations and investigations has improved and provides a clear record of action taken to ensure young people who have made allegations, and staff subject to the allegations, are protected as far as possible. However, there are significant shortfalls in the training provided for staff in safeguarding and child protection. Several staff, including the manager, have not completed recent training in this area and some have had no training at all. The manager states that training has now been arranged and is due to take place shortly. However, a number of staff have been working with vulnerable young people without the benefit of current knowledge in safeguarding practices. This does not provide adequate protection for young people. As a result,

p.7

Safeguarding children and young people

the welfare and protection of young people are not adequately safeguarded.

p.7

Safeguarding children and young people

Young people's behaviour is improving and there has been no physical intervention for a substantial period of time. The staff encourage and reward positive behaviour and any negative behaviour is subject to consequences. These are appropriate and discussed with young people who are encouraged to comment. This enables young people to understand the consequences of their actions and improve their behaviour.

p.7

Safeguarding children and young people

The home has a missing from care policy and protocol and the recording of any absence is satisfactory. The number of missing and absent incidents has significantly reduced as staff work with young people to discuss their triggers and concerns. The home has responded well to concerns in relation to sexual exploitation and has worked closely with other agencies to ensure young people are protected from inappropriate relationships.

p.7

Safeguarding children and young people

Young people are not, however, adequately protected from unsuitable persons working in the home. Although the home has detailed recruitment information for its permanent staff there is insufficient information in respect of the agency staff used in the home. This means safer recruitment practice is not consistent and as a result young people are not adequately safeguarded.

p.8

Safeguarding children and young people

Regular fire drills are held and fire alarm systems are checked as required. This means young people are aware how to evacuate safely in the event of a fire. However, not all staff have completed fire safety training and as a result may not be competent in ensuring sufficient precautions are taken to prevent fire or what to do in the event of a fire.

p.8

Leadership and management

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

p.8

Leadership and management

The home has failed to meet two of the three compliance notices from the last inspection. This gives rise to concern about the fitness of the provider and the Registered Manager. The manager has not received training in a number of mandatory areas such as safeguarding, medication and fire safety. The home has not demonstrated a clear capacity for improvement. This is evidenced through the manager’s poor quality assurance systems, the failure to maintain a clean and appropriately maintained home and significant shortfalls identified in relation to staffing, recruitment and training. In addition to the two unmet compliance notices a further six breaches of regulation have been identified and one failure to meet national minimum standards. These impact on the care, welfare and safety of young people.

p.8

Leadership and management

The manager has made some amendments to an old development plan for the home but this does not provide an adequate picture of what the home has achieved or the plans for the future development of the care. The home therefore lacks direction and does not promote improvement. The home has a good statement of purpose which has been updated to provide stakeholders with an understanding of the service currently provided.

p.8

Leadership and management

Staff lack training in a number of key areas, notably safeguarding, medication and fire safety. The home continues to use a large number of agency staff which have not received any training in self-injurious behaviour. This means staff are not sufficiently competent to meet the needs of young people.

p.8

Leadership and management

Staff are supervised regularly and for senior staff this is further enhanced through senior team meetings. Staff benefit from detailed daily handovers which ensures they are aware of any current issues within the home. Team meetings provide staff with the opportunity to share any concerns and they also benefit from support provided by the psychotherapist. This enables staff to gain some understanding of the complex behaviours presented by young people.

p.8

Leadership and management

The monitoring of the home by the manager is inadequate. The review of care is not sufficiently evaluative and does not provide detailed information on how the home can improve. Young people are not consulted as part of the monitoring. This means the quality of care and welfare of young people is not sufficiently monitored. The manager does however provide notifications of significant events as required and these are sent in a timely manner.

p.9

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.

p.10

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.

p.10