Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

Unique reference number SC032838 Inspector Gillian Walters Type of inspection Full Provision subtype Residential special school (>295 days/year)

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Registered person Appletree Treatment Centre Limited Registered person address Appletree School Natland KENDAL Cumbria LA9 7QS Responsible individual Clair Ann Davies Registered manager Amanda Jayne Fishwick Date of last inspection 04/02/2014 2 of 10 Inspection date 06/08/2014

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Previous inspection good progress Enforcement action since last inspection none

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Overall effectiveness good

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

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Overall effectiveness

Children settle quickly into this home and enjoy an excellent quality of care that enables them to make good progress and achieve good outcomes in their lives. Children placed in the home have experienced considerable and significant trauma in their lives. For many, this means that they have intense feelings of insecurity, a poor trust of adults and difficulties in forming positive attachments. However, the home provides a structured and highly nurturing environment that enables them to feel safe and appropriately secure. Children share meaningful and trusting relationships with staff and say they feel safe and happy living in this home.

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Overall effectiveness

Children are well supported to deal with early trauma. Placement planning is thorough and comprehensive and well-structured to consistently support children’s emotional and psychological needs. Therapeutic support is central to the care provided and the home has well-established arrangements for ensuring staff have good knowledge and understanding of children’s individual and personal support needs.

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Overall effectiveness

Children are actively encouraged to participate in their care planning. They are supported to express their wishes and views about the care they receive, influencing day-to-day arrangements concerning their care. Placement planning documents are produced in a child-friendly format, using simple jargon-free language. This is 3 of 10 helpful in engaging young children and ensuring they have a good understanding of what is planned.

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Overall effectiveness

Mangers have a good understanding of the homes many strengths and appreciate where improvements can still be made. The shortfalls identified as a result of this inspection have had no immediate impact on children and relate primarily to further improvements in the home’s management. 4 of 10

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Information about this children’s home

This is a privately owned residential special school, which is also registered as a children’s home. It provides a service to eight children, between the ages of six and 12 years, who experience emotional or behavioural difficulties.

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Inspection date Inspection type Inspection judgement

04/02/2014 Interim good progress 18/09/2013 Full good 05/02/2013 Interim good progress 20/08/2012 Full good

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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 managers and staff are clear about their roles and responsibilities. The level of delegation and the responsibility of the manager and staff, and the lin of accountability, are clearly defined (NMS 21.4)  ensure that in relation to Regulation 34, the monitoring report that is complet and sent to Ofsted identifies any trends and issues of concern arising from monitoring of matters set out in Schedule 6. (Volume 5, statutory guidance, paragraph 3.14) 5 of 10

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Outcomes for children and young people good

Young people enjoy certainty and stability in this home. They quickly adjust to the structure provided and understand the expectations placed on them living in close proximity to other children. They benefit from a highly nurturing approach that enables them to feel safe, secure and relaxed. Children successfully develop positive attachments with staff enabling them to experience appropriate affection and feel cared for. One social worker commented of a child, ‘He has settled in very quickly. Overall the home provided him with a safe environment of nurture.’

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Outcomes for children and young people good

Children achieve good attendance in education as their school is independently operated by the provider and is linked to the home’s premises. Children make good educational progress in relation to their starting points, especially improving their basic skills in literacy and numeracy. Learning opportunities are creatively constructed. As a result staff are able to successfully gain children’s interest and engage them positively in their education. One parent commented. ‘Academically my son has made significant progress. Previously he wasn’t able to stay within a classroom. Now the teacher has captured his attention he is more included as part of the class and no longer needs 1:1 support.'

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Outcomes for children and young people good

Young people, as far as is consistent with their care plan, receive good support from staff to maintain and re-build relationships with family members that are important to them. Their specific arrangements are clearly detailed in placement planning to ensure that children and staff share a clear understanding of what is planned and agreed. One parent commented, ‘Contact is good. It was alternative weekends but has recently changed to every weekend. Staff work with me and the manager is always available at the end of the phone. Staff are very supportive and flexible.’

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Outcomes for children and young people good

Young people are able to access locally both routine and specialist health care support to meet their individual needs. Young people benefit specifically from the home’s arrangements with a private therapeutic service that provides a range of art and play therapies. The service is successful in working directly with children of such young years and providing advice and guidance to staff. Therapists are able to provide children with good opportunities to explore and make sense of previous traumatic events that they have experienced. They also provide regular guidance and support that informs the care and support children receive. As such, children are provided with the support they require to help them move on with their lives. One Independent Reviewing Officer commented of a child, ‘He has made such huge strides since coming to this home. Staff made in-roads with him quite quickly. They have done a grand job with him.’

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Quality of care outstanding

Children benefit from living in a warm and highly nurturing environment with a staff team that are fully committed to ensuring that they experience appropriate affection, support and care that is successful in promoting their physical, psychological and emotional well-being. As a result children value the excellent relationships that they have developed with many staff. Children know that they are accepted and equally valued for their individual personalities and unique qualities.

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Quality of care outstanding

Children speak highly of staff and particularly identify the fun times they spend together as what is important to them. Children are encouraged to follow their own personal interests and activities. This means that they have a clear sense of their own identity and opportunity to take part in things that makes them happy. For some this includes music and dance for others it can be scooter riding at the skate park or bird watching in nature reserves. As such, young people enjoy a range of activities that provide good fun, entertainment and exercise. Some activities, such as cubs and music and dance classes have proved particularly successful. Young people have been able to engage positively with their community, socialising and make friendships with other children living in their locality.

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Quality of care outstanding

Children are central to the planning process and are consistently consulted for their views and wishes. Young people are encouraged to have their say about likes and dislikes, what will make them feel safe and cared for. Staff are attentive to young people’s wishes and ideas and ensure that these are appropriately documented to ensure successful implementation. For example, one child identified the security of an open tent across his bed as helpful in promoting his bedtime routine and reducing his anxiety and this arrangement has been implemented. Children have no doubts that they have a voice in this home. They identify house meetings as specific times when they can provide staff with their ideas and make requests. Children identify a number of staff including the home’s manager as someone they could speak with should they have a worry or concern. Young people are familiar with the home’s arrangements

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Quality of care outstanding

for making complaints and as such feel assured that any matter would be fairly dealt with by the home’s manager.

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Quality of care outstanding

Children’s health and education needs are prioritised and successfully incorporated into placement planning. Children’s needs are clearly assessed and documented. Plans are subject to regular review to ensure that the care and education provided meets with their current personal needs. Staff are enthusiastic in promoting young people’s progress and achievements. For example, staff will often read stories to children and encourage them to read to themselves for pleasure. This positively encourages and develops their literacy skills.

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Quality of care outstanding

Both parents and placing authorities express a high degree of satisfaction with the quality of care that is provided to children in this home. A social worker commented, ‘The home provides a therapeutic, relaxed and nurturing environment. There are regular care team meetings with the school principal, children’s home manager and 7 of 10 therapist; sometimes also a senior teacher. As such I get a very clear picture about his care.’ A parent said, ‘Staff are very, very supportive and make me aware of any issues. They encourage my son to get in touch with me daily by phone. The care he is provided with is exceptional’

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Keeping children and young people safe good

Children say that they feel safe and well cared for by the staff team. Children accept that as peers they do have times when they bicker and fall out but mostly they share positive relationships and avoid bullying behaviour. The home has good staffing levels that enable close supervision of children and enable staff to intervene quickly should any issues arise between them.

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Keeping children and young people safe good

Children rarely absent themselves from the home. However, on occasions when this has happened, children have remained within sight of staff and have returned themselves to the home. Staff are familiar with the procedures to follow in such instances to ensure the safety and swift return of children to the home. Staff ensure that children are routinely spoken to following such events to understand the reason for their absence and prevent future incidents. Staff educate children on the potential dangers and risks in their community to ensure that they are suitable encouraged to avoid situations that may put them at risk of harm.

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Keeping children and young people safe good

A completed annual assessment of the location of the home appropriately details the action taken to determine its suitability and address any potential risks identified. This means that the provider has taken all reasonable steps to ensure that children are safely located and that all known risks are dealt with.

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Keeping children and young people safe good

Staff receive regular training in child protection and behaviour management. This includes the safe use of physical intervention. The home has undertaken some useful analysis in relation to those occasions when physical intervention has occurred, As such, staff have good information to assist them in de-escalating behaviour displayed at particular times of day and recognising when individual children may be most vulnerable and likely to exhibit behaviour that may put themselves or others at risk. Consequently, for many children the trend is that physical intervention is reducing. Staff have agreed revised strategies for supporting children at particularly difficult times to promote the successful management of children’s behaviour without physical intervention.

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Keeping children and young people safe good

Young people’s behaviour is positively promoted by the visible use of incentive charts and rewards. Young people respond well to this and take great pride in their personal achievements. They enjoy the sense of competition and fun and are enthusiastic to participate in the challenge. Sanctions are rarely used. However, on those occasions when a sanction has been made, children are helped to understand the consequence as it relates to their behaviour. There is good management oversight of all disciplinary measures used to ensure they are effective in promoting positive 8 of 10 behaviour.

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Keeping children and young people safe good

The home responds appropriately to all reported concerns ensuring that they are treated seriously and fully investigated. There is good co-operation with the Local Authority Designated Officer. This means that transparency exists, successfully demonstrating adherence to procedures that effectively promote children’s safety and well-being.

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Leadership and management good

Although judged as good there are some outstanding features evident within the home's leadership and management.

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Leadership and management good

The home has a suitably qualified manager who has worked in the home since October 2013. She has recently been appointed and confirmed as the home’s Registered Manager. She possesses a Level 5 award in Leadership and Management and has relevant previous experience in working with children with emotional and behavioural difficulties. She demonstrates strong leadership skills and is passionate to advocate for the children in her care ensuring that they achieve good outcomes. She has been nominated to complete the organisation’s in-house diploma course to further develop her knowledge and skills in working with young people that have suffered significant trauma in their lives. This is an extensive learning programme that will commence in September 2014.

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Leadership and management good

At the last interim inspection on the 4 February 2014 the home was judged to be making good progress. One requirement was made to improve the quality of independent visits to the home. This has been suitably addressed. A regular selection of young people, parents and social workers are now consulted by the independent visitor and have a consistent opportunity to contribute their views and influence the quality of care provided.

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Leadership and management good

Staff benefit from regular supervision and regular meetings with a visiting psychologist and play and art therapists. These arrangements provide staff with good opportunities to receive advice and professional support, ensuring that consistent guidance is shared in relation to the emotional needs and behaviour management of individual young people.

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Leadership and management good

The Registered Manager has a very visible presence within the home and makes a considerable contribution to supporting both staff and children. Although, there is a management team within the home to support the Registered Manager in her role, clarity does not appear to exist in relation to their specific roles and responsibilities. Consequently, the Registered Manager assumes responsibility for a wide range of tasks that diminishes her available time for strategic and improvement planning. Placing authorities speak highly of the new manager, identifying the value that she has brought to the home. One social worker commented, ‘I find her extremely 9 of 10 professional and capable. She has an excellent relationship with this child. She is fully aware of the children’s risks, how they are reported and managed.’

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Leadership and management good

Good quality assurance arrangements exist to monitor the quality of care provided within the home and to determine how well it functions to safeguard young people. External monitoring takes place with the appropriate frequency and comprehensive reports are received by Ofsted within the required timescale. These demonstrate a good evaluation of the home’s performance, identifying areas of strength as well as weakness in practice that mangers and staff can address.

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Leadership and management good

The Registered Manager is proactive in monitoring the activity and performance of her service. She has maintained and developed existing data collection systems that have enabled her to identify particular trends and patterns in relation to individual children’s behaviour. This has informed the implementation of alternative strategies and initiatives that have shown success in positively promoting children’s behaviour. However, although good evaluation of activity within the home has occurred and been documented, this was not clearly expressed in the three-monthly review of monitoring activity report that the Registered Manager provided to Ofsted. Consequently the report fell short in reasonably demonstrating the home’s analysis of all issues monitored and how effectively these were being managed.

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Leadership and management good

The home has a current development plan in place that identifies priorities for young people, staff and the home and progress to date. The Registered Manager has a sound understanding of the key strengths of the home and the areas that of practice that she wishes to further develop.

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Leadership and management good

Young people’s individual records are well maintained and organised. They provide easy access to essential documentation concerning their placement, progress and achievements. All records are stored securely within the home maintaining young people’s rights to privacy and confidentiality. 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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