Children's Home run by Five Rivers Child Care Limited in Wiltshire

Unique reference number SC059717 Inspector Heather Chaplin Type of inspection Full Provision subtype Children's home

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Registered person Five Rivers Child Care Limited Registered person address 47 Bedwin Street SALISBURY SP1 3UT

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Responsible individual Richard Marshall Cross Registered manager Christina Wainwright Date of last inspection 31/12/2013 2 of 13 Inspection date 09/07/2014

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Previous inspection satisfactory progress Enforcement action since last inspection none

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Overall effectiveness good

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

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Overall effectiveness

Young people at this home say that they have made very overall good progress since they arrived. Although young people have complex needs, these are well met within the home. This has led to long term, generally stable placements which have brought about clear benefits to young people.

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Overall effectiveness

Young people say that they have improved their life chances in terms of their education, health, self esteem and independence. They are happy in the home and value the support they receive from the dedicated staff team.

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Overall effectiveness

Quality of care is extremely good in this home. Recently, there has been some violence towards staff. However, this has been addressed and relationships between staff and the current young people, are warm and respectful.

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Overall effectiveness

The Registered Manager is highly professional and competent. She ensures that her staff team is very well supported, with clear objectives and boundaries to help them meet young people's needs.

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Overall effectiveness

Young people confirm that staff work very hard to keep them safe. Some young people occasionally engage in risk-taking behaviour, but they understand the risks and confirm that staff try hard to advise and support them. There have been a 3 of 13 number of incidents when young people went missing from home, but this has been addressed proactively.

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Overall effectiveness

Staff in the home generally have an exceptionally good understanding of safe working practice. The home works extremely effectively with other agencies to keep young people safe. Although there have been a number of restraints since the last inspection in December 2013, the vast majority of these have been appropriate. However, there have been two incidents when a young person was restrained by a single member of staff, which is against company policy. The Registered Manager identified and addressed this immediately, and no harm was done. However, because the potential impact on the young person was significant, a requirement has been made.

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Overall effectiveness

There is also a minor shortfall in recording telephone verification of staff references, which the company manages centrally. For these reasons, the judgement for safeguarding is adequate rather than good.

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Overall effectiveness

The home has exceptionally strong and effective leadership and management. The manager's monitoring systems are extremely robust, with clear and coherent recording systems and dedicated oversight. Any issues arising in the home are responded to immediately. This has enabled the home to achieve generally good outcomes for young people with very complex needs. 4 of 13

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Information about this children’s home

The home is one of four settings in the locality which are owned and managed by a national company. There are operational links with the organisation's fostering service and school. The home is registered to care for up to six young people who may have emotional or behavioural difficulties. The home currently accommodates girls only.

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Inspection date Inspection type Inspection judgement

31/12/2013 Interim satisfactory progress 07/08/2013 Full good 28/11/2012 Interim satisfactory progress 26/06/2012 Full adequate

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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 that no measure of control or discipline which is excessive, unreasonable or contrary to paragraph (2) shall be used at any time on children accommodated in a children's home. In particular, continue to support staff to ensure that they follow the company's physical intervention policy correctly. (Regulation 17 (1)) 31/08/2014

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Recommendations

5 of 13 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 telephone enquiries are made as well as obtaining written references; in particular, ensure that the outcomes of telephone enquiries are fully recorded on staff files. (NMS 16.1) 6 of 13

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Outcomes for children and young people good

In spite of some recent risk-taking behaviour, young people currently living in the home have made very good progress in terms of their emotional resilience and confidence. Risk-taking behaviour has reduced significantly over time, as a result of the nurturing, supportive care they receive.

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Outcomes for children and young people good

Young people say that they have benefitted enormously from living at the home, and they have been there for several years. This has provided them with stability and consistency of care. Young people particularly value their relationships with staff. They confirm that they are a great deal calmer than when they first arrived in the home and consequently, enjoy a much greater quality of life. As a result, they feel safe and have started to make constructive plans for the future.

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Outcomes for children and young people good

Young people currently living in the home are approaching the age of 18. As they will soon be living independently, they have been given increasing responsibility for managing their own day-to-day programme. The majority of the time, they manage this well.

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Outcomes for children and young people good

Some young people occasionally briefly return to behaviours that pre-date their arrival in the home, but they do now at least make an active choice to do so, informed by a reasonable understanding of the associated risks. For example, the most recent incident was triggered because young people met others in the community who were a negative influence. As a result of their developing insight, they have now discontinued these associations. Young people are well aware that their placement could end sooner than they would like, if they do not keep themselves safe. Because they want to stay in the home for as long as possible, they are willing to engage with staff and other agencies, and allow them to help.

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Outcomes for children and young people good

Young people say that they have received a great deal of formal therapeutic support, and now feel ready to move on from this. They confirm that their medical needs are very well met. They receive a healthy, balanced diet. Young people enjoy being consulted about the home and have participated in planning and refurbishing their bedrooms.

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Outcomes for children and young people good

Young people have considerable educational potential. They undertook a number of GCSEs and have already completed level 1 in catering at the local college. They will be starting the level 2 course in the coming year. They have a long term plan to go to university, but in the meantime have worked in a number of part-time jobs to gain experience and skills. This shows that young people are preparing effectively for a career and are fully engaged in the local community.

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Outcomes for children and young people good

The young person who has recently moved on from the home attended the 7 of 13 company’s own school. This young person had 100% attendance, although she sometimes returned to the home if she found the situation in school too challenging. Over the year in which she was at the home, this young person learned to reduce the incidents of avoidance until she was engaging in school for complete days. This is a positive outcome for her.

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Outcomes for children and young people good

Some young people arrived at the home with limited experience of genuine friendships. This situation has improved greatly and young people now have normal friendships within the community. They enjoy free time, invite their friends to the home for dinner and can stay with them overnight, with permission from the social worker. This reflects a healthy teenage lifestyle.

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Outcomes for children and young people good

Young people in the home are able to contact their families, if this has been agreed with their placing authorities. For reasons unconnected with the home, this has not been possible for the most recent residents.

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Outcomes for children and young people good

Young people are able to budget effectively, manage their own laundry and plan their meals. They have excellent cookery skills, often preparing evening meals on their own or with staff. They can evaluate information about their educational and employment options. This shows that young people have made good progress in preparation for their future lives.

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Quality of care good

Relationships between the staff and young people are spontaneous and warm, but respectful. Young people are in no doubt that staff care about them and are consistently concerned with their welfare. The home is particularly good at adjusting interventions and advice according to young people’s age and level of independence. This means that young people who are approaching adulthood are supported to make positive decisions in preparation for living in their own accommodation.

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Quality of care good

Behaviour management is sound and consistent. The Registered Manager ensures that staff maintain clear boundaries to provide young people with structure, routine and appropriate support. This helps young people to feel secure, so that they can begin to develop and gain in confidence. There are monetary incentives in place, based on points accumulated during the week. This system has worked well for young people currently in the home, and has helped to bring about positive changes in behaviour.

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Quality of care good

Young people are well aware of how to raise a complaint, but have chosen not to do so. They confirm that any issues would be addressed promptly. When complaints have occurred in the past, the Registered Manager has dealt with these extremely well and has taken on learning from the experience.

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Quality of care good

Young people’s wishes and feelings are considered at all times. They receive 8 of 13 frequent, dedicated link worker sessions, to ensure that any day-to-day issues are addressed. They say that they can talk to any member of the staff team and that they make a major contribution to the day-to-day running of their home. For example, young people chose their own room and décor. They requested and received a sofa, so their room is very much their own space. Young people fully participate in day-to-day decisions that have an impact on them. This ensures that they have a sense of ownership and some measure of control over their own lives, which makes them feel valued and respected.

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Quality of care good

Each young person is cared for in line with their unique identified needs. Placement planning is very detailed and clear, so that staff are fully aware of what they have to do to look after each young person. There is very good liaison with placing authorities to ensure that social workers are kept fully informed of developments and progress.

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Quality of care good

The home is well placed to care for young people from minority ethnic backgrounds, because the staff team is exceptionally diverse. This provides young people with excellent role models and supports them in their understanding of both genders, different cultures and nationalities.

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Quality of care good

The home is proactive in promoting education. Staff work hard to support school attendance and to raise young people’s aspirations. Consequently, young people have gained confidence in their abilities and are starting to make the most of the opportunities available to them.

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Quality of care good

The home ensures that young people’s healthcare needs are very well supported. The service provides good quality psychological support for young people, and consultation for the staff team. This supports effective behaviour management and brings another level of expertise, which assists the staff in managing any incidents productively.

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Quality of care good

Young people who take medication are encouraged to do so responsibly. Medication systems in the home are managed very well, to ensure that medicines are safely kept and administered in line with the prescription.

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Quality of care good

The home is located in a quiet residential area of a small city. The Registered Manager is currently completing her location risk assessment, in line with pending regulatory changes.

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Quality of care good

The home provides an exceptionally pleasant, attractive environment for young people. Bedrooms are spacious and nicely decorated; young people are fully involved in choice of décor and furnishings. There is a good-sized, attractive garden which is well maintained for young people’s enjoyment and relaxation. 9 of 13

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Keeping children and young people safe adequate

Young people currently living in the home are approaching adulthood. They have made enormous progress in keeping themselves safe and allowing staff to take care of them. They enjoy free time and are almost completely independent. Most of the time, they manage these responsibilities well. However, there are some occasions when they revert to past patterns of behaviour and put themselves at risk. There was a six-month gap between the two most recent incidents, so this is an infrequent occurrence.

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Keeping children and young people safe adequate

The home’s actions to help keep young people safe are effective. These are informed by sufficient training and an intelligent understanding of the risks faced by vulnerable young people. These actions have included putting in one-to-one staffing and waking nights to help a young person reduce risks from self-harm. The plan to move this young person was brought forward in light of the changing situation.

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Keeping children and young people safe adequate

Other young people agreed to have their mobile phone checked for messages that might indicate incipient risk. An alternative semi-independence placement is being sought to help a young person move into their adult years with some continuing measures of safety and support in place. Young people receive constant advice and reassurance about keeping themselves safe.

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Keeping children and young people safe adequate

Relationships with other agencies, such as the police, are exceptionally good. The home calls a multiagency meeting every time there is a serious incident, and their contact with safeguarding partners is comprehensively logged. The manager is proactive and assertive in getting other agencies to listen. When told that there was nothing that there was no safeguarding issue because the young person is nearly 18, the manager was clear that there was a significant risk because of the young person’s previous history. The police have come to the home on a number of occasions to speak with young people and establish positive relationships with them. This has had a positive impact on young people’s understanding of risk.

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Keeping children and young people safe adequate

In addition, the company has a robust risk assessment tool for use in identifying risks of sexual exploitation. Because staff are well trained, they complete this realistically, so that it can be effective. Staff are extremely well supported in understanding risk taking behaviours through the company’s psychologist, who provides additional supervision and training. This means that the staff have a very good awareness of risk and are consequently equipped to respond to it.

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Keeping children and young people safe adequate

Young people confirm that they feel very well protected and are safe in the home. There is no bullying and when there have been incidents in the past, this has been dealt with very quickly.

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Keeping children and young people safe adequate

Although there have been a number of incidents when young people apparently were missing from the home, the statistics are skewed by the very prompt reporting to the 10 of 13 police in relation to one particularly vulnerable young person. The older young person came back to the home later than her agreed time on many occasions, but she has often been with a female friend who is well known to staff and who poses no risk. Incidents of being absent and missing are very low for this young person, and have reduced over time.

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Keeping children and young people safe adequate

All the physical interventions in the home since the last inspection were related to an urgent need to keep one young person from harming herself or others. Staff and the Registered Manager have a very good understanding of self harming behaviour and are careful not to feed into the emotions that lead to this. This is achieved through calm and professional but low key interventions. Physical intervention has only been used as a last resort. The overwhelming majority of interventions have been appropriate, although tow were not. On one occasion, a young person was restrained in a prone hold by a member of staff acting on their own, which is against company policy and also, contrary to the training for this method of restraint. This potentially placed the young person at risk, so a requirement has been made, but the manager had already identified and addressed the matter as soon as it occurred.

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Keeping children and young people safe adequate

The home has robust systems in place for ensuring that prospective staff are safe to work with children and young people. Three staff files seen were well organised and contained all the required documentation. References are verified by telephone, and this is noted with a signature and date, but there is no record of the conversation. A recommendation has been made.

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Keeping children and young people safe adequate

The home has very effective systems for recording any safeguarding issues. There have been no allegations against staff since the last inspection. The home is secure from intrusion and provides a safe physical environment for young people. Health and safety and fire safety checks are conducted within the recommended timescales. Many of these checks are conducted more frequently than the minimum required. This helps to ensure that young people live in a safe home.

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Leadership and management good

This is a very well managed home. The Registered Manager holds a management qualification at level 5 and has worked with young people for 15 years. She was registered for this service on 29 November 2012. This means that she is well qualified and experienced to manage the home.

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Leadership and management good

There have been no complaints since the last inspection. Previous issues with neighbours have been resolved. The manager worked hard to communicate with local residents and they were invited into the home for tea and cupcakes. This enabled them to meet the young people and establish a positive relationship with the home. The police wrote to the home to thank them for the work done in the neighbourhood. 11 of 13 The requirements and recommendations from the last inspection have been addressed. The home continues to strive for improvement.

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Leadership and management good

There was one recommendation made at the last inspection. This related to shortening the timescales when completed Regulation 33 reports are received by the home and by Ofsted. This has now been addressed. The home has a very effective Regulation 33 visitor who is independent of the company’s management structure. Her reports are detailed and contribute to driving improvement.

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Leadership and management good

The home has an effective Statement of Purpose which contains all the information required to inform placing authorities and others about what the home can offer. The document has recently been updated and was sent to Ofsted as required by regulation. The Registered Manager monitors the home’s activities and progress extremely effectively. Her monthly monitoring is summarised into three monthly review reports and sent to Ofsted. The manager is fully aware of everything that takes place in the home and takes swift action to tackle any areas of concern that arise.

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Leadership and management good

The Registered Manager has involved staff and young people in the home’s development plan. This helps to ensure their ownership of the plan and fosters commitment to improvement. The manager is able to demonstrate that both young people who have resided in the home recently have improved as a result of the care provided.

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Leadership and management good

The home is well resourced in material terms and has sufficient staff to meet the young people’s needs. Young people have access to transport to take them to places of interest and for appointments, should they need support. The home is maintained to a high standard and staff work very hard to keep the environment freshly decorated and attractive.

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Leadership and management good

The home is fully staffed and when there are gaps in the rota, regular sessional staff who are known to the young people are deployed. This helps to ensure that young people are looked after consistently.

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Leadership and management good

Staff receive excellent supervision and support. Trainee staff are enthusiastic about their role and confirm that they have learned a great deal since arrival. They value the experience of established staff and welcome the good quality training on offer from the company. Staff confirm that they have received a good quality and comprehensive induction, and also training in key areas such as mental health, self harm and child sexual exploitation. Three more recently appointed staff are currently undertaking level 3 qualifications.

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Leadership and management good

The home has excellent record keeping. Files are extremely well ordered and are organised to ensure that information can be accessed quickly and efficiently.

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Leadership and management good

Notifications have been sent to Ofsted in a timely manner. When inspectors have 12 of 13 contacted the home to discuss notifications, it is clear that staff have acted appropriately in each instance. Practice and protocols are always reviewed in the light of every incident, which helps to keep young people safe. For example, after recent incidents of self harm, the home revised strategies to further reduce risk. In spite of recent concerns about some young people’s behaviour, positive and assertive leadership has ensured that risks are constantly re-evaluated and managed. Website: www.ofsted.gov.uk

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Leadership and management good

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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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