Swanwick Lodge

Unique reference number SC038719 Inspection date 19/03/2014 Inspector Paul Scott / Gaynor Moorey Type of inspection Full Provision subtype Secure Unit

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Date of last inspection 22/01/2014 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 secure children's home is managed by a local authority. It is approved by the Department for Education to restrict young people's liberty. As well as the living accommodation, education is provided on site in dedicated facilities.

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Brief description of the service

The children's home can accommodate up to 16 young people, who are aged between 10 and 17 years. Admission of any young person over the age of 10 but under 13 years of age requires the approval of the Secretary of State.

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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 was an unannounced inspection of the residential provision of the home. At the last inspection in January 2014 the home was judged to be inadequate. Managers have responded positively by addressing the concerns raised at the previous inspection. This includes addressing all of the requirements and the one recommendation.

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Overall effectiveness

Young people are generally positive about the care and support they receive. Staff are clearly committed to meeting the needs of young people and provide them with good opportunities to find stability and plan positively for their futures. As a result, young people are achieving good outcomes in relation to their emotional resilience, behaviour management and educational achievement.

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Overall effectiveness

Relationships between staff and young people are strong. Young people confirm they feel valued and respected and that their views and opinions are listened to and acted upon. Care planning and care practice is highly individualised and based on rigorous assessment and review. Young people's health needs, some of which are extremely complex, are particularly met well. This is because young people have good access to a range of healthcare professionals that ensure their physical, emotional and psychological health needs are consistently met. Young people's safety and well-being is promoted and young people say that they feel safe. Many aspects of safeguarding practice have been improved to ensure young people are kept safe and secure. However, these will need time before the full impact of their effectiveness can be assessed in detail.

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Overall effectiveness

An improved managerial approach ensures the home is run more effectively. Managers are maintaining a more strategic oversight that increases accountability and ensures staff take responsibility for their own practice. This, coupled with a more robust response to addressing shortfalls has resulted in the home making considerable progress in a relatively short period of time. Managers and staff demonstrate a strong commitment to ensuring the home continues to move forward in the best interest of young people.

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Overall effectiveness

Three recommendations for improvement have been made. These relate to storage of medication, procedures for risk led searches and consistency of records. None of these shortfalls have impacted negatively on young people's welfare.

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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 medicines which are kept in the home are stored securely; in particular that the key to the medication cabinet is secured in accordance with homes policies and procedures (NMS 6.14)  further improve the procedures for countering risks of self-harm or suicide by undertaking searches of children’s bedrooms when levels of risk are increased (NMS 23.4)  ensure information about the young person is recorded clearly and in a way which will be helpful to the young person when they access their files now or in the future; in particular that all files are maintained consistently to evidence the progress young people have made while living at the home. (NMS 22.5)

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Outcomes for children and young people

Young people benefit from good individualised support which helps them grow in confidence and to understand their past. The key-worker system enables young people to focus on their goals and progress. Regular key work sessions provide an avenue for them to discuss their feelings. Staff are aware of young people's strengths and vulnerabilities and help to nurture their talents and interests. This approach ensures that each young person feels valued and that the care and support they receive really helps them make positive choices in their lives. Young people enjoy a variety of activities. These include badminton, football, weights, the gym and games in the sports hall. They also enjoy a full enrichment programme during the holidays such as fencing, circus skills, surf simulation, music fusion and DJ skills.

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Outcomes for children and young people

Young people benefit from very well planned health services which include access to psychological and psychiatric assistance and counselling if required. The young people particularly benefit from having their emotional health and well-being promoted to a high standard by the staff team. For example, young people receive comprehensive advice and guidance on issues such as sexual health, drug awareness and other areas such as sexual exploitation.

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Outcomes for children and young people

Young people benefit from well-arranged contact. Staff are creative in their thinking about the arrangements, the time spent with visitor and what can be organised so it is beneficial for the young people in maintaining positive contact with their families.

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Outcomes for children and young people

Young people benefit from a good standard of education and the opportunities to experience this as a positive part of their lives. All young people resident at the time of the inspection attend education and had over 77% attendance, since January 2014; 21 per cent of time out of education had been authorised. Young people receive good levels of support from staff. Progress is good when taking into consideration experiences and attendance levels before the young people were admitted to the home.

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Outcomes for children and young people

Young people receive comprehensive support to develop their independent living skills in conjunction with their age. They receive a high level of information regarding social issues such as knife crime, cyber bullying, adult imprisonment and life in a gang. Support offered to young people when in transition and preparing to move on is very good with staff finding the right level of support for each individual young person's needs.

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Quality of care

Young people benefit from a good quality of personalised support and care provided by the staff team. Good, positive relationships with clear boundaries enable young people to develop self-awareness and feel safe.

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Quality of care

Since the last inspection the therapy team at the home has developed a new training course for staff regarding self-harming, the reason behind this behaviour and strategies to work with young people. The training has had very positive feedback from the staff with over 90% saying the training will help them in their relationships and work with the young people. A reduction in self-harming for some young people could be related to a change in approach to how staff deal with these incidents. It is however too early to form a judgement.

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Quality of care

The young people's views are promoted and valued to a good standard. There are numerous formal and informal forums to enable young people to voice their feelings and opinions. Young people are able to influence decisions relating to their daily lives, such as independent living, transition planning and interviewing staff as part of the homes recruitment procedure.

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Quality of care

The complaints process is easy to understand, readily available and used by the young people. They are aware of the system and know the various adults and organisations to whom they can complain. The staff and manager address complaints promptly and ensure that the young people are happy about and understand the resolution to any complaints they have made.

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Quality of care

Young people's comprehensive care plans clearly identify their individual needs. New risk assessment planning now covers areas such as night checks, which are now set on a regular ten minute routine. Care plans and risk assessments contribute to overall information for statutory reviews. Staff are seen to follow up on any information that is missing when a young person is placed at the home.

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Quality of care

Healthy lifestyles are encouraged by the staff who guide young people in choosing healthy menus and encourage them to partake in physical exercise and activities. Staff awareness of each young person's background and vulnerabilities ensures that emotional well-being is promoted to a good standard. Young people's medical needs are over seen by the qualified nurse and systems in place do highlight any shortfall or issue around the administration of medication. However during the inspection it was noticed that although the medical room was locked the key to the medication cabinet was still in the cupboard door with no supervision. This was picked up as part of the internal security checks and immediately addressed.

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Quality of care

Young people are enabled to follow their individual needs, including cultural and spiritual needs. The culture of the home ensures that education is promoted and highly valued. Progress is good, with young people achieving some goals and success that they may have never experienced prior to their admission to the home.

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Quality of care

Young people benefit from living in a home which is maintained to a satisfactory standard. Currently the home is undergoing some renovation and work is being undertaken to ensure the safety and security of the young people. Young people were observed to be happy with their accommodation and were comfortable in their surroundings. The young people are able to decorate their bedrooms and have posters and pictures of their own choosing on the walls. Sleeping-in staff have their own dedicated accommodation.

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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

Safeguarding children and young people is adequate. The home has a child protection procedure that is consistently followed in the event of any safeguarding concerns or allegations. Staff display a sound understanding of key safeguarding matters with child protection training being delivered at regular intervals. There has been one child protection concern since the last inspection. Recording has been improved to ensure there is written evidence that the home's procedures have been fully implemented. Scrutiny of these records confirms that this child protection concern was effectively managed in the best interest of young people, including referral to external safeguarding agencies.

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Safeguarding children and young people

The home has strong links with the Local safeguarding Children Board (LSCB). The Registered Manager is a member of a sub-committee of the Board. The Board have oversight of physical restraint at the home as the Registered Manager regularly provides members with updates on incidents, patterns and trends.

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Safeguarding children and young people

Young people stated that they feel supported, cared for and protected in the home. They say that they can talk to staff if they are feeling anxious and upset and that their concerns are treated seriously. Young people raised no concerns about bullying. Levels of supervision are high and staff are vigilant to the potential for bullying and intimidation brought about by group living.

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Safeguarding children and young people

There have been no incidents of absconding since the last inspection. The home has a procedure and protocol with the local police that supports staff to keep young people safe should there an incident.

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Safeguarding children and young people

Staff show a good understanding of young people's individual behaviours, risks and vulnerabilities, including concerns about suicide and self-harm. Risk management strategies are clearly recorded in individual risk assessments. These documents have been reviewed and updated following the requirements from the previous inspection. They now clearly state how often night staff should check on a young person who is vulnerable or a risk to themselves during the night. A basic requirement of fifteen minute observations is now written into policy and put into practice by staff. Records are maintained of these checks. Managers check these records against CCTV each day to ensure this is embedded into practice. As a result of these changes, highly vulnerable young people are given 24-hour support to help keep them safe.

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Safeguarding children and young people

The home has appropriate policies and procedures regarding the searching of young people, their rooms and communal areas in order to promote safety and well-being. All searches are undertaken appropriately, with respect for young people's dignity and privacy and are fully recorded. Searching of young people is underpinned by a risk led approach. For example, the frequency of searches to communal areas have been increased in response to the risks posed by some young people. However, this principle has not been extended to include young people's bedrooms which are searched weekly. This undermines the effectiveness of this risk led approach and has the potential to compromise the safety of young people and staff.

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Safeguarding children and young people

Staff are trained in the use physical intervention to ensure they are able to use methods appropriately and safely with young people. The home does not use any pain compliance techniques. There is a clear commitment to minimising restraint through use of diversion and de-escalation techniques. During the inspection, several staff were observed managing challenging behaviour in this manner. However, there has been a high number of restraints since the last inspection. This relates mainly to a number of young people with extremely complex needs and challenging behaviours. All incidents of restraint are fully recorded and reviewed by the Registered manager and head of care, including the use of CCTV footage. This ensures practice is appropriate, approved methods are used, any learning points can be identified and good practice is shared.

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Safeguarding children and young people

Positive behaviour is promoted. Young people understand why there are rules and they are familiar with the home's incentive scheme. They feel the incentive scheme helps them to develop positive social skills and behaviour. The scheme has levels from pre-bronze to platinum plus with each level having additional rewards and benefits. Negative behaviour is challenged. Staff take a restorative approach where possible, encouraging young people to rectify their mistakes. Sanctions are used when this is not possible. These are clearly recorded and young people have the opportunity to write their comments about the measure used. This helps young people to develop understanding and responsibility.

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Safeguarding children and young people

The home's policy for the use of single separation is commensurate with government guidance in that young people are only placed in separation when there is a risk to them, others, or there is significant damage to property. Recording formats have been improved and now consistently demonstrate this criteria is met. All incidents requiring separation must be approved by senior staff. When single separation is used, it is used for the right reasons, monitored appropriately and there is a clear focus on reintegration at the earliest opportunity.

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Safeguarding children and young people

No staff have been recruited since the last inspection. Processes for recruiting staff are robust. Staffs are thoroughly vetted and undergo a rigorous interview process. This helps ensure they are safe and have the right skills and competencies to work with vulnerable young people.

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Safeguarding children and young people

Managers have worked hard to ensure security matters are managed more effectively. They are working closely with experts in this field and have established good consultative links with other secure children's homes and prisons. A number of improvements have been made to the environment and the home has a clear plan to make further necessary improvements. Policies have been updated and procedures introduced to further improve staff practice and security in the home. For example, senior staff undertake twice daily security checks to ensure the environment is safe and secure. This is beginning to prove effective in identifying shortfalls in practice and ensuring weaknesses are quickly addressed. There is clear evidence of learning from mistakes, a factor that was not evident at the previous inspection. Staff have been issued with clear directives that ensure they fully understand their roles and responsibilities in this area. Staff show an increased awareness of the importance of

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Safeguarding children and young people

maintaining high standards of security. For example, staff could be seen checking and proving locks to ensure they are fully engaged. These actions have improved young people's safety and well-being and now need to be further developed and fully embedded into practice.

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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

Leadership and management of the home is adequate. Appropriate actions have been taken to address the shortfalls found at the last inspection. This includes the management team acknowledging areas of their own practice which needs to improve. Additional managerial support has provided the leadership team with greater strategic oversight to address the running of the home. A number of improvements have been implemented, however these will need time before the full impact of their effectiveness can be assessed in detail.

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Leadership and management

All requirements and recommendations made at the last inspection have been met. These include ensuring staff complete training in self-harm, receive formal supervision as required and the implementation of consistent working practices. Also, risk assessments and behaviour management records have been improved, a more diligent approach to security is being taken and there is a more rigorous approach to the monitoring of standards of care. The addressing of these shortfalls indicates a robust response from the management team who display appropriate aspirations to learn, consolidate and improve.

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Leadership and management

A suitable number of staff are available to meet the assessed needs of young people. The care team are made up of a good balance of staff in terms of age, gender and experience. Staff say they feel well supported and note that expectations of practice have been raised since the shortfalls identified at the January inspection. Regular team meetings occur which ensures they are able to consider the needs of each young person and how these are to be met. The recent implementation of monthly meetings for the night care team is a positive move. This has resulted in a greater focus on consistent working practices and in particular the regularity at which vulnerable young people are monitored.

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Leadership and management

Staff receive appropriate levels of induction, training and guidance which matches their learning and development needs; this includes clinical support from the on-site therapy team. New staff say they are, ‘well supported and welcomed’, and confirm they undertake a number of shadow shifts before working independently. Statutory courses include first aid and physical intervention, with the home providing specific training when necessary. All care staff have recently attended training in self-harm which they stated was, ‘extremely valuable’ in enhancing their abilities to care for the current cohort of young people. This approach ensures staff are provided with appropriate resources to meet the complex, and at times, highly risky behaviours of young people.

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Leadership and management

The home is suitably monitored to ensure standards of care are routinely assessed, considered and evaluated. The Registered Manager and head of care complete monthly reviews of care which take account of the key areas of service provision. The format for undertaking these has been improved upon and includes a newly introduced file auditing process. The local authority complete monthly regulation 33 visits as required with reports providing a suitable critique of the home. The findings are now evaluated at the monthly performance action group which focuses on addressing shortfalls and improving practice. This group provides increased strategic oversight and rigour to ascertain how well the home is functioning, what areas need improvement and how this will be achieved.

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Leadership and management

Records are kept secure and in general are maintained to a suitable standard. These provide a reasonable overview of the young person’s care needs and the progress they are making. However, not all of the information kept on each young person’s files, are consistently maintained. For example a majority of files contain a useful chronology of the young person’s progress at the home, although one file viewed did not have this. Despite this shortfall not posing any risk to young people a valuable opportunity to fully evidence the life of the young person since being admitted was missed.

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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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