Children's Home run by SureCare Residential Ltd in Hertfordshire

Unique reference number SC470645 Inspector Gwen Buckley Type of inspection Full Provision subtype Children's home

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Registered person Surecare Residential Limited Registered person address 19e North Street, 2nd Floor Bishops Stortford Hertfordshire CM23 2LD Responsible individual Simon Peter Barr Registered manager Karen Savill Date of last inspection N/A 2 of 9 Inspection date 29/05/2014

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Previous inspection N/A Enforcement action since last inspection none

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Overall effectiveness inadequate

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

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Overall effectiveness

The staff team consists of dedicated, caring managers and staff who work well with others to ensure care and services are provided to young people that meets individual needs. Staff are highly motivated to bring about improvement in a young person’s life and to keep them safe. Young people are extremely positive about the staff and say they always have a member of staff to talk with if they are upset or want support. Attendance at education facilities is good with some young people making excellent progress at school.

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Overall effectiveness

Support for young people to maintain contact with those people who are important to them is extremely well managed. Parents and external professionals are very complimentary about the quality of care provided and feel the staff are very good at keeping them up to date with events.

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Overall effectiveness

As a result of this inspection developments are needed to the home’s procedures for: recruiting staff; preparing young people for adult living; fire safety; the behaviour management policy and external monitoring of the service. 3 of 9

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Information about this children’s home

This children's home is owned by a small private organisation. It is registered to provide care and accommodation for up to 4 young people who have emotional and behavioural difficulties and learning disabilities.

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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 where the Regulatory Reform (Fire Safety) Order 2005 applies to the children's home the registered person must ensure that the requirements of that Order and any regulations made under it, except for article 23 (duties of employees), are complied with in respect of the home (Regulation 32 (1A)) 05/07/2014

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Reg. Requirement Due date

17B (2001) keep under review and where appropriate revise the behaviour management policy (Regulation 17B (2) (a)) 05/07/2014

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Reg. Requirement Due date

(2001) develop recruitment processes to ensure the registered person does not employ a person to work at the children’s home unless that person is fit to work at a children’s home (Regulation 26 (1) (a)) 05/07/2014

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Reg. Requirement Due date

(2001) ensure the monthly monitoring visitor inspects the premises of the children’s home, and such of the children’s home’s records, as the independent person requires. Specifically reviewing incidents and reports relating to restraint to establish if the conduct of staff promotes the wellbeing of the young people. (Regulation 33 (8) (b)) 05/07/2014 4 of 9

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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

 further develop the independence training to ensure children receive care whi helps for them prepare for independent living and supports them into adultho so that they can reach their potential and achieve economic well-being. This relates to developing the initial assessment process and resources influencing development of the independence plan (NMS 12)  ensure that in line with Statutory Guidance all staff and children who have witnessed the restraint, or been involved in any way, should be given the opportunity to be debriefed about the incident to inform the strategy needed prevent recurrence (Volume 5, Statutory Guidance Paragraph 2.103)  ensure the induction new staff induction training is to the Children’s Workforc Development Council’s induction standards. (NMS 18.3) 5 of 9

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Outcomes for children and young people good

Young people attend schools and further education placements that meet their very varying needs. A head teacher stated that it is unbelievable the progress a young person has made, saying, ‘It is fantastic progress from their starting point.’ The effective support and encouragement provided to young people ensures school placements are maintained. Family members confirm arrangements for visits are extremely well managed and they are kept informed of progress at school as well as in the home. This ensures young people enjoy positive experiences with friends and family and young people are maintaining their educational placements and make progress at school.

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Outcomes for children and young people good

Young people's health needs are identified and met effectively. Young people see health professionals, including mental health staff, when they have a specific need. Staff acknowledge the young person’s rights to make decisions while continually giving reminders about the importance of staying healthy and making positive choices. Young people receive advice on health matters and keeping safe in the home and community. This helps young people identify risks so that they can keep themselves safe and well.

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Outcomes for children and young people good

Young people state that the planned menu bears no resemblance to the meals provided and is a work of fiction, while acknowledging they can be fussy eaters. As a result of listening to the young people the manager has very recently appointed a member of staff with specific responsibility to develop the menu. This member of staff is charged with getting young people more involved in shopping and developing their knowledge and understanding about the importance of healthy eating.

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Outcomes for children and young people good

Young people learn and practice basic skills, such as the importance of exercise, shopping, budgeting and cleaning. The views of young people in the home vary about how confident they are to manage on their own when they leave. The initial assessment process does not always identify strengths as well as areas where young people need to develop skills and confidence. There are limited resources for staff to use when developed independence plans. As a result, preparation for adulthood and independent living skills are not always focused on identified areas which does not enable young people to be confident about their ability to manage when they leave. Those young people who are anxious about moving on and disagree with review decisions about their future are encouraged to use their advocate to support them.

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Quality of care good

6 of 9 There are extremely good relationships between staff and young people. Young people are able to share their views directly with staff and the Registered Manager. Staff listen to what young people say and as a result, they can effect change.

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Quality of care good

External professionals are very complimentary about the quality of support young people receive. A parent of a young person recently left the home reported that she is ‘very proud of the person (her daughter) has become.’ Communication with parents is good with one saying, ‘I cannot fault the staff commitment to the children and support provided to our family.’ Family members consider the senior team are very thoughtful about how best to support young people who have complex needs.

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Quality of care good

Staff look at individual care plans to ensure the needs of young people are being met and are not allowed to drift. There is a range of healthcare services to which young people have access if required. Staff are meeting the health needs of young people and working well with others to ensure the services they need are provided. For example, young people access services promoting their health and well-being: such as opticians; dentists; doctors; sexual health advisors and mental health professionals. Staff are supported in caring for the young people by a psychologist who oversees the care provided and is also available to young people if needed. Young people are helped to understand their history and develop a trust in the staff group. This means young people can talk about their feelings and engage with different professionals as required.

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Quality of care good

Staff, that are trained to, safely administer medication and records are well maintained. Young people, when safe to do so, are encouraged to take responsibility for their own medication for limited periods. This limits young people, assessed as safe to administer, from developing their ability to manage their own medication in a safe caring environment.

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Quality of care good

Young people have access to a very good range of activities at the home and in the community, which reflects their individual interests and abilities. These include football-training, horse riding, working with animals and volunteering in the local community. Young people were looking forward to various activities planned for the summer holiday, which they have been consulted about. Important certificates and photographs maintained on young people’s files, ensure they are kept safely for future reference.

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Quality of care good

The home is well decorated and furnished providing a welcoming and comfortable environment for young people to live in. Young people are able to personalise their own bedrooms and they take pride in the home and help to keep it tidy.

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Keeping children and young people safe inadequate

7 of 9 Young people feel safe and do not have concerns about their safety. They are confident staff will take action to keep them safe; they report that there is no bullying allowed at the home. Staff understand and can implement the child protection procedures to help ensure that young people are kept safe; sufficient staffing levels help to ensure the safety of young people.

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Keeping children and young people safe inadequate

Young people very seldom go missing from the home. A missing-from-home protocol is in place confirming relevant professionals and agencies are notified when such events occur. Records reflect that appropriate action is taken to ascertain the circumstances of the young person going missing and their whereabouts. Incident records reflect the actions taken when the young person was missing and action taken on a young person’s return.

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Keeping children and young people safe inadequate

There is a stable staff team and young people have good relationships with staff they know and trust. A psychologist helps staff understand the behaviours young people display so that staff are aware of how best to support, advise and guide young people. As a result, restraint is extremely rare with this occurring only once since the home opened in November 2013. A management review of the incident leading to the restraint took place. It concluded that de-escalation of the situation could have been managed differently and advice on how to improve practice given to staff. This review also concluded the use of the front door as a barrier was the right one in this circumstance and kept the young person safe. A non-approved restraint used was discussed with staff involved. The review concluded that this was appropriate in the circumstance but this decision was not recorded. The home’s behaviour management

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Keeping children and young people safe inadequate

policy clearly states that none approved restraints should not be used: it does not say what should happen if one is used. Young people who witnessed the restraint were not consulted as part of the debrief or spoken to about the incident.

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Keeping children and young people safe inadequate

Sanctions are seldom used. When they are needed, clear records are made, which help young people understand about expected standards of behaviour.

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Keeping children and young people safe inadequate

The staff recruitment processes are not robust. In one instance, a member of staff was employed before satisfactory explanations were obtained on information that came to light during the recruitment process. The Registered Manager was not aware of this situation and is not involved in assessing the suitability of references. Although this did not impact on the individual children in the home, in this instance, the flaw in the process is a significant concern.

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Keeping children and young people safe inadequate

The home is safe and secure and all checks on equipment are undertaken as required. Fire drills are undertaken on a very regular basis. Staff and young people undertake a fire drill as part of their induction into the home. They practice these regularly and are confident they can get out safely during the day. However, no night time drill has taken place since the home opened to establish if staff and young people respond appropriately at night. The fire procedure is not robust: it does not specify what action staff should take if young people refuse to leave the building. 8 of 9

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Leadership and management adequate

This is the first inspection since the home opened. The Registered Manager is very experienced she was previously a Registered Manager and has been at this home since it opened. Staff and young people say she is very approachable and always there for them. The Registered Manager has suitable qualifications, he has obtained a National Vocational Qualification at Level 4 in both management and health and social care.

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Leadership and management adequate

External monthly monitoring visits take place regularly and generally consider relevant issues during the visits. Young people are provided with the opportunity to talk with the visitor, giving young people an avenue to express their views. However, restraints are rare and when one did occur the visitor did not scrutinise the restraint and related incident records effectively. This meant that they did not question the appropriateness of a non-approved restraint or the use of a locked door. This means the visitor could not accurately report on the arrangements in place to keep young people safe or ensure that the quality of care is maintained.

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Leadership and management adequate

Very regular supervision is provided to staff who feel well supported in their work with the young people. Staff have many opportunities to discuss practice, they receive both peer and individual sessions with a psychologist who supports them support the young people. At these times, they focus on meeting young people’s needs, improving practice and the care provided. Staff report that ‘we are well trained and advice and guidance is always available from the senior management team and external consultants.’ This means staff understand the needs of young people and how best to meet these.

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Leadership and management adequate

All care staff employed more than six months have a relevant level 3 or 4 award. A few care workers are undertaking the level 5 award. New staff undertake a six week induction. The registered person was unable to evidence that this meets the Children and Young People’s Workforce induction standards. All staff have first aid training and young people are given the opportunity to attend a first aid course, one has successfully obtained this and is rightly proud of this.

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Leadership and management adequate

Regulation 34 monitoring undertaken and reports of the findings sent to Ofsted as required. The views of parents and young people influence the development of care within the home. As a result, parents and young people feel respected and listened too. Staffing levels ensure the safety of young people. When needed ‘bank’ staff are used which helps provide consistency of care for young people. 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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