Children's Home run by Crystal Care Solutions Limited in Stoke-on-Trent

Unique reference number SC358638 Inspector Elaine Cray Type of inspection Full Provision subtype Children's home

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Registered person Crystal Care Solutions Limited Registered person address Nelson House, Boat Horse Road Kidsgrove STOKE-ON-TRENT ST7 4JA Responsible individual James Maxwell O'Leary Registered manager Kevin Mark Brammer Date of last inspection 24/01/2014 2 of 12 Inspection date 28/05/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness adequate

Outcomes for children and young people adequate Quality of care adequate Keeping children and young people safe adequate Leadership and management adequate

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Overall effectiveness

Young people make some good progress and their safeguarding outcomes significantly improve. Placing social workers have a very positive view of the home and the staff’s ability to keep young people safe. They say, ‘the home has done a phenomenal job. They have looked after a very complex young person who is now going through good transition.’

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Overall effectiveness

Young people grow in confidence and self-esteem. Their developing emotional resilience enables young people to re-form relationships with their families. Young people experience opportunities to develop maturity and personal awareness to facilitate their transition into adult life.

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Overall effectiveness

Staff are well-trained. They implement the day-to-day routines for young people, ensuring their individual needs are explored and facilitated. Staff place a strong emphasis on relationship building and young people make progress due to experiencing trusting relationships.

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Overall effectiveness

This service continues to develop with a relatively new manager and a newly emerging team of motivated staff. Policies, procedures and processes are generally well-managed. This service clearly places the welfare and safety of young people at the core of the service. However monitoring processes have not picked up the 3 of 12 recording and care framework shortfalls identified on this inspection. Young people’s engagement with education, work and healthcare remains a challenge for the staff team. Young people will also benefit from improvement of the physical environment in the home.

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Overall effectiveness

There are five statutory requirements and seven recommendations set as a result of this inspection. 4 of 12

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Information about this children’s home

The children's home is part of an organisation operated by a private company. The home is registered to care for one young person aged eight to 17 years, with emotional and behavioural difficulties.

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Inspection date Inspection type Inspection judgement

24/01/2014 Interim good progress 01/05/2013 Full good 17/12/2012 Interim inadequate progress 13/06/2012 Full good

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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

12A (2001) keep under review and revise the placement plan as necessary (Regulation 12(2)) 30/06/2014

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Reg. Requirement Due date

(2001) ensure that any activities in which children participate are so far as reasonably practicable free from avoidable risks. This is with particular regard to the risk assessment of activities relating to independence programmes (Regulation 23 (b)) 30/06/2014

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Reg. Requirement Due date

(2001) ensure a sufficient number of suitably qualified, competent and experienced persons working at the children’s home. This is with particular regard to the amount of shifts worked by the Registered Manager and availability to carry out managerial 30/06/2014 5 of 12 responsibilities (Regulation 25(1))

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Reg. Requirement Due date

(2001) ensure that all parts of the children’s home used by children are kept in good structural repair externally and internally (Regulation 31(2) (d)) 30/06/2014

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Reg. Requirement Due date

(2001) maintain a system for monitoring the matters set out in Schedule 6 and improving the quality of care provided in the children’s home. (Regulation 34(1)) 30/06/2014

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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

 encourage children to take appropriate risks as a normal part of growing up (NMS 4.4)  ensure children understand their health needs, how to maintain a healthy lifes and to make informed decisions about their own health (NMS 6.2)  ensure children who are able and wish to keep and take their own medication can do so safely (NMS 6.14)  review the arrangements for young people no longer receiving compulsory ful time education to participate in further education, training or employment (NM 8.9)  implement a written policy that clarifies the purpose, format and content of information to be kept on the registered person’s files and information to be k on the child’s files. Ensure staff understand the nature of records maintained follow the home’s policy for the keeping and retention of files. There is a syste in place to monitor the quality and adequacy of record keeping and take actio when needed (NMS 22.1)

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Recommendations

 ensure information about the child is recorded clearly and in a way which will helpful to the child when they access their files now or in the future (NMS 22.  ensure each child’s Placement Plan is monitored by a key worker within the ho who ensures that the requirements of the plan are implemented in the day-to day care of that child. (25.2) 6 of 12

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Outcomes for children and young people adequate

Young people are very positive about their experiences of living at this home. They clearly value their relationships with staff. These positive experiences are exemplified by the comment, ‘It would be spoiling me if the home was made better. I have already got the best staff ever here.’ Social workers say young people have ‘self- confidence, self-esteem and are so much safer’ since coming to the home.

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Outcomes for children and young people adequate

Young people make good progress in terms of behaviour. They develop better understanding and tolerance of others. For example, young people improve attitudes towards women is a direct result of living at the home.

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Outcomes for children and young people adequate

Young people are safer because they are better at managing their own risk-taking behaviours. For example, young people who experience significant challenges in terms of self-injurious behaviour have fewer incidents since living at this home. They are also proud of developing strategies to manage anger and aggressive behaviours. This growth in emotional resilience and maturity is as a result of enjoying positive relationships with staff. Young people learn to form and enjoy respectful relationships. They learn to replicate these experiences with friends and families. Some young people now look forward to returning to live with their families. Social workers see this progress as a direct result of young people living at the home.

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Outcomes for children and young people adequate

Young people feel valued because they are consulted about their placements and running of the home. For example the young people say the independent person regularly visits and chats to them about the home.

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Outcomes for children and young people adequate

Young people grow in confidence and they now access and enjoy a range of activities. Joining clubs in the community has resulted in young people making new friends, learning new skills and growing in confidence. However, and despite being offered a range of education and employment opportunities, young people are poorly engaged with education and work. Young people’s potential, as they imminently enter adulthood, is compromised due to poor outcomes in terms of access to work and further education.

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Outcomes for children and young people adequate

Improvements in young people’s health are intermittent. They poorly engage with opportunities to develop their awareness about being healthy. For example young people currently choose not to engage with therapeutic agencies and miss other routine medical appointments and check-ups. Young people resist staff encouragement to eat healthily, maintain a healthy weight and they continue to smoke cigarettes.

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Outcomes for children and young people adequate

While acknowledging the progress young people make in terms of self-confidence, behaviour and family contact; the above limitations compromise outcomes for young 7 of 12 people. These poor outcomes result in an adequate judgement for overall outcomes for young people living at the home.

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Quality of care adequate

Young people live in a very respectful and interactive environment. Staff place great emphasis on maintaining positive relationships and role modelling. The courteous behaviour of young people throughout this inspection exemplifies the impact of this positive environment on young people.

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Quality of care adequate

Clear policies, procedures, assessment and care planning processes support young people’s transition to and from the home. The comprehensive care planning framework maps out the arrangements for the day-to-day care of young people.

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Quality of care adequate

The care planning framework promotes assessment of need, maps out aims and objectives and promotes regular review of young people’s outcomes and progress. Young people’s self-esteem and confidence develops because they receive consistent feedback about how they are doing. They discuss aims and progress on a monthly basis with key workers. Social workers and independent reviewing officers can monitor progress because the home sends them monthly summary reports.

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Quality of care adequate

The positive outcomes for young people to return to live with their families are as a direct result of staff working in partnership with parents and social workers. Plans to prepare young people to leave the home result from staff facilitating progressive and well planned contact agreements.

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Quality of care adequate

The care planning framework extends with a detailed and comprehensive independence programme. Support for young people to learn skills and help them to live more independently is a key focus for the home. However opportunities to develop young people’s independence are not fully harnessed. There is a lack of connectivity between young people’s incentive plans and areas for independence. For example, young people’s challenges with getting up and going to work or college are not a target for incentive plans. Rewards for going to bed on time continue as young people consistently achieve in this area.

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Quality of care adequate

Regular key working supports the care planning framework. Key working records show some key links with placement plan aims and objectives. However a lack of connectivity continues to emerge. For example key workers and young people discuss poor sleep patterns, impact on health and possible motivation to find work. However new targets to support and address these areas are not brought forward into young people’s care plans.

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Quality of care adequate

In addition key working records show little discussion and evaluation of how young 8 of 12 people are actually doing. Records are sometimes repetitive and do not reflect the young people’s contribution and reflections. These records provide poor accounts of young people’s experience and their journey while living at the home.

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Quality of care adequate

Staff present a concerted commitment to help young people to explore education and employment opportunities. Social workers and other professionals value the efforts made by staff and say ‘Nothing is too much trouble’. Professionals acknowledge the shortfalls in formal education and employment outcomes are as a result of the complex needs and behaviours presented by young people. Staff continue to explore work opportunities as young people prepare to live in a different area away from the home.

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Quality of care adequate

Young people’s identity and individuality are valued by staff and is covered in the care planning format. Staff show a good awareness of equality and diversity. However the care plans' aim to explore, ‘the world through learning, conversation, experience and exploration via various tools and technologies’ is not fully harnessed. For example, this aim is not included in the independence and education programmes for the young people who refuse to engage with formal education and employment.

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Quality of care adequate

Staff monitor, support and encourage young people’s health with detailed and individualised healthcare planning. Safe and effective procedures for the storage and administration of medication also protect young people’s health.

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Quality of care adequate

Staff maintain good access to a range of healthcare agencies in order to meet the complex physical, emotional and mental health of young people. However young people often refuse medical and health interventions. Social workers’ comments such as, ‘The team are very proactive in making appointments. Staff will not leave it. Encourage, but also substitute with good first aid treatment and follow up treatment. They try different strategies’ sum up the tenacity and commitment of staff.

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Keeping children and young people safe adequate

Young people are safe as a result of robust and rigorous safeguarding procedures. Levels of safety are effective because staff implement agreed policies and procedures. Safeguarding strategies have impact and are effective because they respond to the significant vulnerability of and levels of risk presented by the young people living at this home.

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Keeping children and young people safe adequate

Behaviour is well-managed in the home. Behaviour management is effective because staff have a good connection with and insight into the young people’s feelings and emotional well-being. This approach is productive in supporting young people to understand their reasons for going missing from care. As a result young people take more responsibility for their behaviours, their missing from care episodes reduce and they are safer. 9 of 12 The effective focus on positive behaviour management is reflected in the few and low level use of physical interventions in the home. Young people are encouraged to discuss and reflect on their behaviour. These interactions enable young people to maintain positive relationships. They are also able to take more responsibility for managing their own behaviours. Use of physical intervention only happens as a last resort and to promote the safety of young people and staff in the home.

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Keeping children and young people safe adequate

Safeguarding strategies focus on risk assessment and results in high levels of staffing for managing behaviour. Risk assessment starts with an initial pen picture and profile of young people; giving staff good insight into the risks and positive connections presented by young people.

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Keeping children and young people safe adequate

Staff are well trained in child protection, behaviour management and health and safety. As a result all staff are aware of their own roles and responsibilities and other agencies involved in keeping young people safe. They have good experience in maintaining links with the police, the local safeguarding children's team and the youth offending service (YOS). Social workers are very complimentary about staff supporting young people on YOS programmes and their reduction in offending.

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Keeping children and young people safe adequate

Young people’s safety is maintained with a comprehensive range of risk assessments and management strategies. However some specific risk management processes are not appropriately adjusted to reflect young people’s pending transition to adulthood. For example there are no strategies in place for young people to manage self- administration of medication. In addition transition plans do not address how young people will adapt from high staffing levels in the home to living with far less support when they leave the home.

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Keeping children and young people safe adequate

Some risk assessments are generic and do not relate to the individual profiles and circumstances for some young people. For example the bullying risk assessment gives general terms about managing bullying. The management strategies relate to group living and these arrangements are not always in place for young people living at this home. In addition a lone working risk assessment is in place. Some young people receive very high levels of staffing. Lone working is risk assessed as high. However some older young people are preparing for independence. They will move to placements where support is significantly reduced. Risk management strategies do not reflect strategies for managing the potential risks for this transition.

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Keeping children and young people safe adequate

Young people’s safety is promoted because health and safety checks are an integral part of the daily running of the home. For example young people know what to do in the event of a fire.

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Keeping children and young people safe adequate

Young people are protected with robust recruitment processes, including checks on agency staff who come to work at the home. Visitors are checked, vetted and monitored. 10 of 12

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Leadership and management adequate

The manager has developed and improved aspects of the home in order to meet the new legislative framework. The home’s Statement of Purpose is recently updated; most usefully with information about the home’s complaints’ procedures. Young people can find out about the home with a written young people’s guide.

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Leadership and management adequate

The manager works a number of shifts while managing the home. His relationships with young people clearly have a positive impact on young people's outcomes and progress. The Registered Manager allocates one day per month to exclusively to deal with managerial responsibilities such as monthly checks and staff supervision. Managerial time and activity is not sufficient. While monitoring is regular it has not picked up some of the administrative shortfalls as identified in this inspection.

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Leadership and management adequate

Young people are looked after and safe because staffing levels are effectively managed to meet the needs and potential risk of the young people.

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Leadership and management adequate

Young people experience a strong sense of permanency and consistency because there is a stable core team of staff. While agency staff are sometimes used; young people maintain a good sense of security. They get to know the agency staff well because the same staff are used and work with the core staff team. Agency staff say they feel confident and equipped to work with the young people due to good staff support and effective information sharing.

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Leadership and management adequate

Young people are looked after by staff who are supported with regular supervision and up to date training. But poor recording compromises the quality of staff supervision. Some records are repetitive, lack evaluation and compromise the quality assurance of staff performance. For example, the quality of and shortfalls in key working have not been picked up via the supervision process.

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Leadership and management adequate

Staff make concerted efforts to improve the physical aspects of the home. However damage caused by young people living at the home compromises these efforts. The physical presentation of the home is poor. Newly painted walls remain bare and often dented. The carpets are worn, frayed and badly stained in places. The home does not present as homely due to lack of pictures, ornaments and soft furnishings.

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Leadership and management adequate

Strong relationships with staff and the completion of monthly consultation forms ensures that young people’s views are known. and their contributions are valued. Young people's ideas are listened to and their concerns and complaints are taken seriously. The staff work hard to enable young people to explore and resolve their concerns. The manager and staff make clear efforts to address issues and improve the service.

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Leadership and management adequate

Managers have a good understanding of the strengths and areas for development of the service. Developments in building a strong core staff team are a credit to the manager and have resulted in improvements in behaviour of the young people. The 11 of 12 home development plan exemplifies the commitment to driving improvement in the home. Website: www.ofsted.gov.uk

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Leadership and management adequate

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Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

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Judgement Description

Good A service of high quality that exceeds minimum requirements.

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Judgement Description

Adequate A service that only meets minimum requirements.

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Judgement Description

Inadequate A service that does not meet minimum requirements.

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Information 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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Information 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 framework of inspection for children's homes.

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