Children's Home run by BREAK in Norfolk

Unique reference number SC040191 Inspection date 05/03/2014 Inspector Stephen Halliley Type of inspection Interim Provision subtype Children's home

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Date of last inspection 15/08/2013 Website: www.ofsted.gov.uk

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Brief description of the service

This children's home is owned by a registered charity. The home provides long-term accommodation for up to four young people with emotional and/or behavioural difficulties.

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The inspection judgements and what they mean

Good progress The children’s home has demonstrated continued improvement in quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the large majority of recommendations that were raised at the previous inspection. Satisfactory progress The children’s home has maintained quality of care and outcomes for children and young people and where appropriate has addressed all requirements and the majority of recommendations that were raised at the previous inspection. Inadequate progress The children’s home has failed to address one or more requirements and/or has not met the majority of recommendations and/or the quality of care and outcomes for children and young people have declined since the last full inspection.

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Progress

Since their previous inspection the service is judged to be making inadequate progress .

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Progress

This home was last inspected by Ofsted in August 2013 and judged to be providing an adequate service. There were five requirements and five recommendations made at that time. The home has failed to satisfactorily address two of these requirements and one of the recommendations. Together with further shortfalls being identified which impact on the outcomes and well-being of young people this home is judged to be making inadequate progress.

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Progress

The home has made clear progress in improving their recording systems and staff now complete the majority of records fully and clearly. This more careful approach to the content and quality of recording, together with more stringent managerial monitoring, has ensured that four of the previous recommendations have been met. This has also led to the previous requirement about the completeness of restraint records being met.

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Progress

The home have updated their statement of purpose and this includes clear information about the range of needs the home is intended to meet. A more collaborative working arrangement with specialist health providers, clearly linked to the keyworking arrangements, has also ensured young people are provided with guidance, support and advice on health and personal care issues appropriate to their needs. While young people continue to smoke they are now more aware of the potential risk associated with smoking and more able to make informed decisions about their actions.

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Progress

At the last inspection a requirement was made linked to the home having delays in sending notifications of significant events to the regulator Ofsted. At the time of this inspection a notification was again delayed by two weeks indicating that this requirement has not been met. It is imperative notifications are sent without delay to ensure that Ofsted has a clear view of what is happening in the home.

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Progress

The previous inspection also highlighted issues about medication not being given to young people in line with the prescription and records of the administration of medication being incomplete. At this inspection it was noted that on one occasion prescribed medication had not been given to a young person despite them being in the home. On another occasion a young person was given a large quantity of tablets to take on home contact. This was not checked with other staff, the risk assessment was not looked into to check for any evidence of self-harm and the medication was not clearly recorded. These shortfalls could potentially have very serious consequences for young people. At the last inspection several omissions were noted in the records of the administration of medication and a recommendation was made to improve this. Overall the recording has improved due to the use of a more rigorous management monitoring system being implemented from January.

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Progress

Omissions in recording are now picked up swiftly but they have continue to be made by staff. As a result this recommendation has not been sufficiently addressed.

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Progress

There have been three complaints made by one young person since the last inspection. Two of these have not been followed through appropriately by managers. There is no record of any investigation into the complaints or of the resolution. One of these related to a complaint against staff and, though the Registered Manager has acknowledged receipt of the complaint, no further action has been taken. The Local Authority Designated Officer was also not notified and this means the home have failed to comply with their own safeguarding policy. This does not indicate that young people can make complaints and representations secure in the knowledge they will be taken seriously and appropriately addressed by staff.

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Progress

The monitoring of the home by the Registered Manager has been more regular and robust in a number of areas. However, issues identified through this inspection have not been appropriately acted upon in order to ensure continuing improvement of the quality of care provided in the home. The monitoring of the home by the provider takes place regularly and clear reports of these visits are provided. However, there is insufficient depth in reports on the conduct of the home, specifically in relation to the use of sanctions and restraints and the continued failure by the home to address young people's complaints.

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Progress

The home regularly review and update risk assessments for young people and the premises itself. There has, however, been a failure to link these together. Young people's risk assessments indicate that it may be necessary to lock their bedroom windows on occasion and that young people are known to smoke in their bedrooms. Neither of these issues is addressed in the home's fire risk assessment meaning there is a failure to have a comprehensive and updated risk assessment available.

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Progress

Records of sanctions and restraints are clear and actions taken by staff are appropriate to behaviours observed. These clearly show that young people have been spoken to following the use of sanction or restraint and on most occasions their views are clearly noted although this has not been the case with more recent sanction records.

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Progress

Social workers report that the home takes appropriate action to safeguard young people and that they are kept safe while living in the home. All young people have a stable educational placement, appropriate family contact and the home co-ordinate the teams of professionals working with young people well. While this indicates that young people are making some progress this inspection has identified serious concerns about the home’s ability to fully comply with regulations and national minimum standards.

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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 the implementation of a written policy which is intended to safeguard children accommodated in the children's home from abuse or neglect (Reg 16 (1) (a)) 31/03/2014

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Reg. Requirement Due date

(2001) ensure the registered person makes suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received in to the children's home (Reg 21 (1)) 31/03/2014

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Reg. Requirement Due date

(2001) ensure that any medication which is prescribed for the child is administered as prescribed and that a written record is kept of any medication administered to a child (Reg 21 (2) (b) (c)) 31/03/2014

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Reg. Requirement Due date

(2001) ensure a written record is made of any complaint, the action taken in response and the outcome of the investigation (Reg 24 (5)) 31/03/2014

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Reg. Requirement Due date

(2001) ensure that if any of the events listed in column 1 of the table of schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table (Reg 30 (1)) 31/03/2014

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Reg. Requirement Due date

33 ensure the person carrying out the visit prepares a written 30/04/2014 (2001) report on the conduct of the home; specifically ensuring sanctions, restraints and complaints are reported upon (Reg 33 (4) ( c))

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Reg. Requirement Due date

(2001) establish and maintain a system for improving the quality of care provided in the children's home; specifically ensuring that shortfalls identified are acted upon to improve the overall quality of care provided. (Reg 34 (1) (b)) 30/04/2014

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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 where any sanctions, disciplinary measures or restraints are used children are encouraged to have their views recorded in the records kept by the home (NMS 3.18)  ensure risk assessments are recorded in writing and regularly reviewed; this is specifically in respect of the fire risk assessment including risk posed by young people who smoke in the building and windows being kept locked. (NMS 10.8).

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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 progress made by the provider since the last full inspection, identifies any further strengths, any areas for improvement and makes judgements as outlined in the Inspection of children’s homes – framework for inspection.

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