Esther House

Unique reference number SC474150 Inspector Emeline Evans Type of inspection Full Provision subtype Children's home

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Registered person Benjamin UK Ltd Registered person address Ascott Lodge Lower Ascott, Wing Leighton Buzzard Bedfordshire LU7 0PU Responsible individual Claudette Elizabeth Deysel Registered manager Gareth Gray Date of last inspection N/A 2 of 11 Inspection date 09/09/2014

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Previous inspection N/A 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 good Leadership and management good

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Overall effectiveness

The home provides good personalised care that supports young people to make good progress in relation to their starting point. Staff place young people's well- being at the centre of their practice. Staff have created effective relationships with education and a wide range of specialist services to embed a cohesive approach to care. Social workers comment that staff are proactive and communicate effectively with them. Young people are benefiting from a nurturing environment with clear boundaries.

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Overall effectiveness

In recent months, the staff and management team have been presented with some challenging situations. Young people are beginning on the journey of reflecting on the impact of their behaviours. The home is working effectively with professionals and the young people to enable a reduction in these behaviours. Young people are making good progress as a result of their placements. They are settled, have formed good relationships with staff and are becoming increasingly involved in various forms of therapy.

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Overall effectiveness

Young people are happy at the home and their family relationships have benefitted from the period of security they have experienced while living there. The views of the young people are central to the running of the home. Consultation takes place regularly and any suggestions made by the young people are acted upon. There is 3 of 11 an excellent relationship between the staff and the young people. The safe and knowledgeable working practice of the staff allows the young people to feel secure.

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Overall effectiveness

One area identified for improvement is to gain consent from placing authorities on the use of surveillance and to ensure their use is documented in placement plans. Four recommendations have been made to further improve outcomes for young people. 4 of 11

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Information about this children’s home

This children's home is registered to take up to four young people with emotional or behaviour difficulties. The home is owned by a private organisation.

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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 any electrical or mechanical monitoring devices for the surveillance of children are only used when conditions are met as detailed in regulation 22. (Regulation 22(1)(a)(b)(d)) 31/10/2014

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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 a night time emergency escape plan is in place and is accessible to children, staff and visitors (NMS 10.9)  ensure that the registered person has a written development plan, reviewed annually, for the future of the home, either identifying any planned changes in the operation or resources of the service, or confirming the continuation of the home's current operation and resource (NMS 15.2)  ensure that sufficient information (written or electronic) is retained at the home, demonstrating that the recruitment and selection of staff consistently follows good practice, and all applicable current statutory requirements and guidance (NMS 16.2) 5 of 11  ensure regular agency staff are provided with formal supervision.(NMS 19.4) 6 of 11

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Outcomes for children and young people good

Young people make positive progress in most aspects of their lives; their emotional well-being and feelings of self-esteem are developing well. Staff support young people to understand and come to terms with matters from their past which are impacting on their emotions and behaviours currently. Young people benefit from this individualised support which helps them grow in confidence. There have been recent admissions to the home which have resulted in new challenges for the staff team. These young people are beginning to settle into their new environment and reflect on behaviours. Staff work consistently with external agencies to address the young people’s individual needs and promote their physical and emotional well-being. The increased support from staff and external specialist agencies ensures young people are able to understand their risk-taking behaviours and consider reducing them. One professional commented, ‘Good support –in a difficult case. They facilitate the

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Outcomes for children and young people good

necessary techniques well with the young person.’

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Outcomes for children and young people good

Promotion of health means young people have an understanding of healthy lifestyles and what this means for them. Increased support from staff and external agencies ensures young people have access to an adequate range of information and advice on health issues. They are able to make informed decisions about whether they wish to take advantage of the advice and support offered. Staff work effectively with professionals to involve young people in discussions around health issues. Young people now engage and regularly attend appointments. Young people presently in placement are committed to therapeutic intervention and the staff team work very closely with these professionals to ensure a holistic approach is achieved. This engagement is central to young people’s development and their emotional welfare.

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Outcomes for children and young people good

Staff have high aspirations for all young people, irrespective of their initial educational starting points. Young people are very well supported to achieve their educational potential. They attend and make good progress either at the organisation’s school or at local schools or colleges. Staff are proactive in securing educational provision. Young people feel well supported with their education and are motivated to succeed.

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Outcomes for children and young people good

Contact arrangements are supported by staff and young people benefit from the continuing links with their families. There has been progress for some young people in this area. Through the support from staff, relationships between young people and their families are starting to be re-built. This practice enables the young people to develop and maintain relationships with the significant people in their lives.

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Outcomes for children and young people good

Young people enjoy various leisure activities and are keen to be involved in the local community. For example, they attend a local yoga class, go to the cinema, bowling and have participated in work experience in a local veterinary surgery. This helps young people build positive peer relationships, increasing their social networks and 7 of 11 integrating in the community.

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Outcomes for children and young people good

Young people receive positive care which promotes their independence. Young people engage in practical skills such as cooking for the home and laundry to prepare them for later life. Young people are also encouraged to try new things and these activities are geared to prepare the young people to move on to independent living.

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Quality of care good

The young people benefit from good supportive relationships from committed members of staff. This enables young people to be able to start addressing some of their emotional and risk taking behaviours. Young people are overwhelmingly positive about the relationships they have with staff. Staff have been presented with a number of challenges since the home opened and they describe this time as ‘difficult’ but they have worked together to support each other. Professionals talked positively about the relationships staff have formed with the young people currently in placement. Comments from professionals include, ‘she has developed really good relationships with staff and they are very good at recognising her needs,’ and ‘the staff relationships with children are very good.’

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Quality of care good

The ethos of working in partnership with young people is fully embedded in the practice of the home. Staff use creative and enjoyable methods to engage with young people and at other times just talk and share experiences. Staff undertake their key worker duties responsibly and efficiently. Other group opportunities are provided for young people to express their views through regular house meetings. Staff appropriately support young people to participate in meetings and make decisions. Records indicate that young people have not made any complaints since the home opened. Staff spoken to felt this was due to a culture of openness which provides opportunities for young people to raise grumbles or concerns without the need to make formal complaints.

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Quality of care good

Staff have a very good understanding and knowledge of the individual needs of young people. Young people are consistently cared for in line with their detailed and comprehensive placement plans and risk management plans. The complex and changing needs of the young people are continually monitored and plans updated by staff following regular consultation with social workers and other professionals. This results in young people having the consistency and individualised care required for them to progress. Young people are very aware of these plans and are centrally involved in reviewing them and giving their opinions on their effectiveness.

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Quality of care good

A range of services are accessed for young people to promote their health, safety and well-being. The home has built up a very positive relationship with the child and adolescent mental health service which provides advice and support to both the young people and staff. This has had a very positive impact in improving emotional and psychological outcomes for the young people. The home works very closely with 8 of 11 the local police who are very positive about how the home is working with and supporting the young people. One professional commented,’ the home has had very challenging young people and we work really well together in coming up with ideas; they are very open to suggestions in how to move forward.’ In addition, the organisation's therapist is available for staff to consult with or to work directly with young people.

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Quality of care good

The home is situated in a residential area within easy reach of local facilities. Young people live in an environment which is decorated and furnished to a high standard, providing a homely atmosphere. The house is set in a rural location and this provides outdoor space for young people. The isolation from a town is not seen as a negative aspect for young people, they are supported with transport to maintain contact with family and friends.

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Keeping children and young people safe good

The relationships young people are developing with staff mean they feel able to talk to staff should they feel worried or upset. Staff are aware of the group dynamics and the effect the young people’s behaviour has on others in the home. Staff are proactive in working with the young people and professionals to create a calm and happy place. Young people report that they have good relationships with the staff in the home. Staff are trained in a range of safeguarding issues and this is regularly reviewed. They have a good understanding of safeguarding procedures and appropriate actions to take in response to any incidents concerning the protection of the young people. Young people are given regular opportunities to discuss ways to keep themselves safe when out in the community. This ensures the young people live in a home which supports them to keep themselves safe.

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Keeping children and young people safe good

The home has had a number of admissions since registration which have presented some challenges to the staff team. A number of notifications of significant events have recently been received into Ofsted. The home followed the correct safeguarding procedures and ensured all necessary people were informed in a timely manner. The manager ensures that all the relevant agencies are informed promptly of any safeguarding issues. A number of professionals were contacted during the inspection process. All spoken to were positive about how the home is working to minimise the current levels of risk and keep young people safe. In particular, all commented on the effectiveness of communication by the home.

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Keeping children and young people safe good

There are a high number of occasions when young people are absent without authorisation or go missing. If young people leave the home and staff do not know where they are, young people’s well-being is the prime concern. There is close and effective liaison with the local police when this occurs. The protocols that are in place minimise risk. Staff respond appropriately in line with specific risk assessments and take into account the particular vulnerabilities of each young person. Young people are given a range of opportunities for support and guidance to consider the reasons 9 of 11 for and potential consequences of their actions. Meetings with all involved in the young person’s care are promptly arranged should this behaviour occur. Staff are working with professionals to look at ways to try and engage young people to focus on the impact of their behaviours.

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Keeping children and young people safe good

The use of bedroom door alarms is currently in operation for the purpose of safeguarding young people. In addition, closed circuit television has been installed in outside areas. The home reports they have verbally sought consent from the placing authorities on the use of this measure. However, they have not formally received this consent. In addition, this use of surveillance is not also detailed in young people’s placement plans.

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Keeping children and young people safe good

Staff are very proactive in promoting positive behaviour and relationships. As a result, young people predominantly behave appropriately and interact positively with each other and staff. Staff are aware that at certain points in therapeutic intervention and when certain life events occur, behaviours increase and staff support the young people during these times. Staff receive appropriate behaviour management training and have a good understanding of individual positive handling strategies. Behaviour management plans are very comprehensive and provide clear guidance on how to respond to specific behaviours with a focus on de-escalation. This has resulted in low levels of physical intervention being used. Young people's behaviour plans and risk assessments are comprehensive and tailored to their assessed needs.

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Keeping children and young people safe good

The home has a thorough recruitment process which ensures all necessary checks are completed before a member of staff starts work. This protects young people from having contact with unsuitable people. However, on one staff file some information was not easily assessable. During the course of the inspection, this information was made available. Young people are protected by good health and safety routines. Frequent fire checks and evacuation drills take place to ensure young people are clear on actions to take in the event of a fire or emergency. However, there is not currently an emergency evacuation plan accessible to young people, staff and visitors for night times when one fire door is locked. This does not enable everyone to be clear on the action to take during the night should evacuation be required.

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Leadership and management good

A Registered Manager is in place at the home. The manager has been in post since February 2014 and is currently undertaking a level 5 qualification in Leadership for Health and Social Care and Children and Young People’s Services. This is the first inspection since registration so there are no previous requirements or recommendation’s to meet. The statement of purpose clearly identifies the aims and objectives of the home and a children's guide is available suitable to the needs of young people that live at the home. This ensures that all stakeholders in the home have a clear understanding of the service provided and the staff team that work there. 10 of 11 The Registered Manager displays a realistic view of the strengths and weaknesses of the children’s home and strives to reach the best outcomes for young people that live at the home. The Registered Manager leads the team well and effectively monitors

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Leadership and management good

the admission of potential new placements into the home. There is not currently a development plan in operation, which does not enable the manager to focus on the future for the home and fully evaluate the progress the home has made.

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Leadership and management good

Staff are enthusiastic and committed to the young people in their care. They have formed good relationships with young people and speak positively about them. Staff numbers, their level of experience and the support provided to them are such that the staff sufficiently meet the needs of the young people. The manager provides and receives regular supervision to ensure that young people are cared for by a team that knows how to meet the diverse needs of the young people. Due to the known and current risks the young people have been presenting they have been assessed as requiring high ratios of staffing. At present, the home is using a small group of agency staff to provide the additional staffing and ensure consistency. This group of agency staff are covering a high number of shifts. However, they are not receiving any formal supervision at present. Staff undertake regular training which provides them with the necessary knowledge and competencies to fulfil their role. Staff have

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Leadership and management good

received training in self-harm and recently in ligature cutting. There is a range of information available to all staff on current behaviours young people are presenting. These are explored thoroughly in team meetings.

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Leadership and management good

There are regular visits to monitor the conduct of the home under Regulation 33 of the Children’s Homes Regulations, and the Registered Manager undertakes quality assurance monitoring checks in line with Regulation 34 on a regular basis. These visits include consultation with, and observation of, children and young people. The manager examines trends and patterns during these processes and information is shared with the staff team.

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Leadership and management good

Records made are clear, up to date and provide a good picture of a young person's stay in the home. This ensures that an accurate history of events is recorded for them, should they wish to look at these records in the future. All significant events are reported to Ofsted as required. 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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