Children's Home run by Bristol City Council in Bristol

Unique reference number SC034184 Inspector Clare Davies Type of inspection Full Provision subtype Children's home

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Registered person Bristol City Council Registered person address The Council House College Green BRISTOL BS1 5TR Responsible individual Karen Mary Gazzard Registered manager Wendy Ann King Date of last inspection 04/03/2014 2 of 11 Inspection date 02/06/2014

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Previous inspection satisfactory progress Enforcement action since last inspection none

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Overall effectiveness inadequate

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

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Overall effectiveness

There are several breaches of regulation which impact on the quality of this provision. Leadership and management arrangements are weak.

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Overall effectiveness

The lack of boundaries and poor response to behaviour management fails to promote positive outcomes for young people. Incidents have led to staff and young people feeling unsafe at times and calling for police assistance. Care planning lacks structure to support young people with their personal development and educational achievement.

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Overall effectiveness

Some young people have enjoyed this placement as they have not been restricted by boundaries, others have not felt safe and have moved on. Staff have developed some positive relationships with young people and continue to support them in the community when they are not in residential care.

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Overall effectiveness

The monitoring arrangements lack rigour and have not been effective to identify the breaches of regulation. Therefore leaders and managers are not fully informed of the inadequate areas of practice. 3 of 11

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Information about this children’s home

This home is one of a number of children's homes operated by a local authority. The home provides care and accommodation for up to five young people of either sex with emotional and behavioural difficulties. The purpose of the home has been to support young people with independent living; this is currently changing to include an assessment of independent skills.

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Inspection date Inspection type Inspection judgement

04/03/2014 Interim satisfactory progress 15/10/2013 Full adequate 30/01/2013 Interim satisfactory progress 08/10/2012 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

4 (2001) ensure the registered person compiles in relation to the children's home a written statement (in these Regulations referred to as ''the statement of purpose'') which shall consist of a statement as to the matters listed in Schedule 1 (Regulation 4 (1)) 14/07/2014

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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 safeguarding and welfare of children accommodated there (Regulation 11 (1)(a)) 16/06/2014

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Reg. Requirement Due date

17B prepare and implement a written policy (in this 30/06/2014 4 of 11 (2001) regulation referred to as the ''behaviour management policy'') which sets out- (a) the measures of control restraint and discipline which may be used in the children's home (Regulation 17B (1)(a)) 17B (2001) prepare and implement a written policy (in this regulation referred to as the ''behaviour management policy'') which sets out- (b) the means whereby appropriate behaviour is to be promoted in the home (Regulation 17B (1)(b)) 30/06/2014

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Reg. Requirement Due date

(2001) maintain in respect of each child who is accommodated in a children's home a record in permanent form which incudes the information, documents and records specified in Schedule 3 relating to that child (Regulation 28 (1)(a)) 30/06/2014

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Reg. Requirement Due date

(2001) ensure that if any of the events listed in column 1 of the table in 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 (Regulation 30 (1)) 02/06/2014

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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)) 16/06/2014

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Reg. Requirement Due date

(2001) ensure that the requirements of the Regulatory Reform (Fire Safety) Order 2005 and any regulations made under it, except for article 23 (duties of employees) are complied with in respect of the home (Regulation 32 (1A)(b)) 16/06/2014

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Reg. Requirement Due date

(2001) subject to paragraph (2), appoint, at the registered provider's expense, an independent person to visit and report on the children's home in accordance with this regulation (Regulation 33 (1)) 02/06/2014

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Reg. Requirement Due date

(2001) establish and maintain a system for monitoring the matters set out in Schedule 6 at least once in every three months (Regulation 34 (1)(a)) 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

 ensure that the wishes, feelings and views of children and those significant to them are taken into account in monitoring staff and in developing the home (NMS 1.7)  ensure the home has a clear written policy on managing behaviour, which inc 5 of 11 supporting positive behaviour, de-escalation of conflicts, discipline, control and restraint, that all staff understand and apply at all times. In particular avoid duplication and maintain one record for physical intervention (NMS 3.3)  ensure there are regular reviews of incidents of challenging behaviour, to examine trends or issues emerging from this, to enable staff to reflect and learn to inform future practice. In particular, implement a system to de-brief after incidents of challenging behaviour (NMS 3.21)  ensure medicines which are kept by the home are stored safely and are accessible only by those for whom they are intended. In particular, maintain a

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Recommendations

record of non-prescribed pain relief medication (NMS 6.13)  ensure staff have access to support and advice and are provide with regular supervision by appropriately qualified and experienced staff. In particular, ensure casual staff receive supervision (NMS 19.3)  ensure that information about the child is recorded clearly and in a way which will be helpful to the child when they access their files now or in the future. Children are actively encouraged to read their files, other than confidential or third party information and to correct errors and add personal statements (NMS 22.5)  ensure that each child's placement plan is monitored by a key worker within the home who ensures that the requirements of the plan are implemented in the day-to-day care of the child. In particular, ensure it is kept up to date. (NMS 25.2) 6 of 11

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Outcomes for children and young people inadequate

The outcomes for young people are inadequate. Weak and inconsistent responses to behaviour management impacts on young people by making it difficult for them to feel safe and stable in this home. The severity of some incidents has been frightening for young people providing a poor experience of this residential placement.

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Outcomes for children and young people inadequate

Young people have formed some relationships with staff however these have been tested at times and some have broken down as staff have been injured through assaults by young people. Opportunities are made available for specialist support with drug use, offending behaviour and emotional well-being. Young people do not always take these opportunities which limits progress with their personal development. Young people who smoke and are involved with drug use are referred to support groups however, their lack of engagement has had minimal impact.

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Outcomes for children and young people inadequate

Young people receive good support with dental care. For some young people this has greatly improved their oral health that had been previously neglected. As young people purchase and cook their own food, they do not always choose a healthy diet; staff provide encouragement and praise those that cook a balanced meal. There are plans to revise the function of this home and to build up young people's skills towards independence. This will provide young people with the opportunity to cook with staff, to learn how to provide a nutritious meal and to gain knowledge about food hygiene.

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Outcomes for children and young people inadequate

Young people have opportunities to contribute to the running of the home through formal house meetings but they are poorly attended. Young people do raise issues with staff members and through key work sessions. Soon after arriving in this placement young people choose items to decorate their bedrooms which personalises their space. Where young people have damaged communal areas of the home there has been a slow response to rectify this. This impacts on the presentation of the home to the young people who live there and any visitors.

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Outcomes for children and young people inadequate

Young people lack routine if they are not in full time education. Young people are not fully engaging with educational provision and consequently are not learning in comparison to their peers. Some young people are sitting exams and securing places at local colleges. Weak boundaries and expectations to be in as late as midnight on school days do not support good outcomes with educational achievement.

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Outcomes for children and young people inadequate

Young people are supported in maintaining contact with their family and friends in accordance with their placement plans. The staff are sensitive to the cultural identity of young people and the need to maintain links with their home communities. Outreach work supports young people and their families in strengthening relationships. 7 of 11 Young people are supported to develop life skills as they are provided with a budget for their food and personal needs. This model of care has provided limited success as young people have frequently spent their money on tobacco and drug use, in place of regular meals.

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Quality of care inadequate

This home has been operating as a residential unit for young people to become independent and live on a budget. The provider has decided to review this function in order to provide care and support for young people during an assessment of their level of independent skills. The assessment will determine where to focus on developing life skills and staff will support young people in these areas. At the time of this inspection the transition was incomplete and many staff expressed confusion about the direction and purpose of the home.

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Quality of care inadequate

Relationships between young people can be difficult at times with challenging behaviour and incidents of bullying. There has been negative impact for some young people living together in this placement, for example an increase in anti-social behaviour. Young people currently in placement have not formed any significant relationships with each other but have formed relationships with some staff members.

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Quality of care inadequate

A lack of boundaries has contributed to inconsistent care. The policies and procedures to support and guide the staff team are not clear. Staff report that managers and colleagues undermine each other's practice, this leads to a frustrated staff team and confused young people.

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Quality of care inadequate

Young people express their wishes and feelings, often through disruptive behaviour. The house meetings are not well attended; young people prefer to speak directly with their keyworker or individual staff member. The local authority holds consultation groups with the children in care council. Young people from this home have so far chosen not to get involved but the results of the recent consultation are posted on the notice board for all to read. An independent advocate is also available to young people through visits and telephone contact.

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Quality of care inadequate

There is good access to health services in the community such as the local surgery, the Child and Adolescent Mental Health Service, the designated nurse for looked after children, dentists and opticians. Contact with these health professionals ensures that young people receive good health care for their physical and emotional well-being. Prescribed medication is suitably stored and administered. Record keeping for non- prescribed medication lacks detail on the quantity held. A running record would ensure a safer system of managing this medication.

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Quality of care inadequate

Care planning is supported by ready access to the information system held by the local authority social workers. These records contribute to young people's care plans; 8 of 11 however, some details in the children's records were noted to be out of date. At the time of the inspection, the staff were providing outreach support to some young people living with their families. This level of intervention supports young people in their community while maintaining the option to return to residential care. Records identify young people's individual needs and cultural identity. Young people are supported well to maintain links with people who are important to them. There is good access to the city that offers a diverse range of resources to support young people in meeting their cultural needs.

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Quality of care inadequate

The options for education are varied. Overall the level of engagement and attendance is poor. Some young people attend mainstream school and others are supported with alternative provision. When young people are not in full time education their day lacks structure and consequently anti-social behaviour escalates. Interests and leisure activities are minimal as young people are on independence programmes and expected to fund activities within their budget. Occasional outings occur with the staff, for example, to the cinema and local events.

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Quality of care inadequate

The house is located in a residential area and on a main bus route. Some areas of the home are pleasantly furnished while others require decoration, cleaning and maintenance. For example the kitchen is scheduled to be refurbished to improve group living arrangements. Equipment that is no longer in use remains on the wall, this detracts from the comfortable setting of the lounge. Young people like their bedrooms and select the colours and decoration that they want.

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Keeping children and young people safe inadequate

Young people do not always feel safe in this environment and on occasion have called the police themselves to report that they are scared and at risk of being assaulted. The lack of boundaries and weak management has led to an escalation of challenging behaviour involving physical assaults on staff and other young people. The level of incidents has involved police intervention leading to young people becoming involved in the criminal justice system.

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Keeping children and young people safe inadequate

Inconsistent responses by the manager and the staff team do not provide sufficient structure for young people. Staff responses to challenging behaviour is ineffective as young people's behaviour has spiralled out of control leading to offending behaviour and police involvement. The use of sanctions lack impact as repeat behaviours continue, for example, smoking in bedrooms. Staff are trained in the use of physical intervention and records confirm it is used appropriately on a few occasions. Sufficient information is captured in the records however, there are two log books in use, this duplication is not necessary and has the potential for confusion among staff and those monitoring these records.

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Keeping children and young people safe inadequate

Staff are not provided with a de-brief following incidents of disruptive behaviour. This can leaves team members feeling emotionally drained and denied the opportunity to 9 of 11 reflect and learn to inform future practice. The staff team lack a cohesive approach to behaviour management. Policies and procedures do not provide sufficient clarity for firm boundaries. Where policies are detailed, these are not followed. For example, the young person's guide states that young people must be in by 23:30 each night, however this boundary has slipped to midnight. Consequently young people have challenged this and stay out even later.

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Keeping children and young people safe inadequate

Some young people have stayed out all night and been reported to the police as missing. Staff make efforts to contact young people when they are not in the home and inform significant people, adhering to protocols for inter-agency working. This collaborative approach focuses on the safe return of young people. Staff are trained in child protection and have good links with statutory and voluntary safeguarding teams.

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Keeping children and young people safe inadequate

Risk assessments for young people are regularly reviewed in consultation with social workers. Young people are not actively involved with this process however, staff openly discuss the risks posed and what can be done to reduce them. For example, the risks associated with drug use has involved inviting specialist workers to meet with young people with the aim of reducing and ceasing such behaviour. Young people have been reluctant to engage with this service.

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Keeping children and young people safe inadequate

Fire safety systems are not sufficiently robust. Evacuation drills are not routinely undertaken. For example, nine months between drills does not provide sufficient practice for young people and staff to vacate the building. Routine testing of the fire system has failed to check all the call points as the manager was unaware of their locations.

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Leadership and management inadequate

The experienced staff team lacks direction and leadership. The management of this home has failed to act effectively in managing the high number of incidents of disruptive behaviour. The manager has been in post since October 2012 and is suitably experienced in residential care. The manager holds a social work qualification and has yet to complete formal qualifications in management.

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Leadership and management inadequate

Staff morale is low following a period of disruption where some staff report they have felt anxious and scared at times. Staff meetings generally have low attendance and this results in lack of discussion and agreement on strategies to follow. More recently a team day provided opportunities for staff to speak with an independent person. This enabled staff members to speak openly about their frustrations and satisfaction with their work to contribute to an action plan for the whole team. Staff report varied levels of support from the management of the home. Some report good levels of supervision and guidance however, many staff report that they are not supported and do not feel listened to. Some regular casual staff do not receive supervision. A further team day is planned to continue with team building and agree the direction of 10 of 11 the home with its revised function and purpose.

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Leadership and management inadequate

Since the last inspection there have been improvements in the way records are held for any young people who go missing. This practice allows for improved monitoring and contains the relevant guidance in one central place. The manager has not met the previous recommendation about improving behaviour management. The manager has failed to fully implement the revised regulations that were implemented in April 2014 and does not hold a copy of these regulations. As a result, the revised statement of purpose does not meet the requirements of the new regulations.

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Leadership and management inadequate

The level of monitoring of this home is weak. Neither the manager nor the external visitor have identified the shortfalls as reported through this inspection. Where failings have been noted, these have not been followed through and have become lost in subsequent reports, one example being the fire evacuation drill. Monitoring records lack detail and do not allow for any analysis or evaluation.

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Leadership and management inadequate

The manager’s annual report written in March 2014 fails to refer to the high number of incidents and disruption within the home over the preceding six months. Serious incidents that warranted the police being called have not always been notified to Ofsted; this oversight contributes to the ineffective monitoring of this service. Without sound monitoring the strengths and weaknesses of this service are not fully identified, therefore any development plan is incomplete.

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Leadership and management inadequate

There is a large staff team at this home, made up of many working part time hours and casual staff. Casual staff are regular, many have been working at this home and other residential settings for several years. There is a breadth of knowledge and skills amongst the staff team. The local authority training programme offers a good range for refreshing skills and personal development. Experienced staff members have not been delegated areas of responsibility within the home, other than acting as key workers for the young people. Some staff members report that they feel their skills and strengths are not recognised by the management of the home and not utilised effectively.

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Leadership and management inadequate

Record keeping is centred on one main log book. Detailed reports are entered here instead of creating an individual record for each young person. This collation is not in line with regulation and hinders any monitoring and evaluation. Records maintained in this way are not helpful to young people when they access their files now or in the future; it also restricts young people reading their records and adding their personal comments.

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Leadership and management inadequate

The staff and manager have developed some good relationships with other agencies such as health professionals, the police, youth offending service and education providers. Social workers report good levels of communication. Website: www.ofsted.gov.uk

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Leadership and management inadequate

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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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