Children's Home run by 4d Care Ltd in Cambridgeshire

Unique reference number SC064557 Inspector Tracy Murty Type of inspection Full Provision subtype Children's home

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Registered person 4D Care Limited Registered person address 8a New Road Mepal ELY Cambridgeshire CB6 2AP Responsible individual Michael Alan Coles Registered manager Andrew Mervyn Bradley Date of last inspection 06/01/2014 2 of 12 Inspection date 11/11/2014

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

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Overall effectiveness

The staff team provide highly personalised and well-planned care for all young people in this home. Detailed placement plans set out the aims and objectives and are fully met. From their starting points, young people make real progress in all areas of their lives. They feel well supported and prepared for their eventual move to independence.

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Overall effectiveness

Young people contribute to all aspects of their care and feel confident in raising any views or issues with the staff team. For some young people, this has been the longest placement they have ever had. Placing authorities consistently praise the staff team for improving outcomes for young people and meeting their holistic needs.

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Overall effectiveness

Young people report feeling safe and very well cared for by all the staff. Risk assessments reflect their individual needs and how they will be met. High staffing levels and imaginative rotas ensure that young people receive very close support and supervision at all times.

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Overall effectiveness

Educational attendance and achievement of young people is good, with many moving on to further education or vocational training courses. Young people enjoy a wide range of social activities and holidays, improving their confidence and self- 3 of 12 esteem. They enjoy regular contact with family members. Contact arrangements are very well supported and facilitated by the staff team.

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Overall effectiveness

Some shortfalls have been identified as a result of this inspection. They have had no adverse impact on the welfare of the young people living in this home. 4 of 12

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Information about this children’s home

The home is privately owned. It is registered to look after a maximum of six young people with emotional and behavioural difficulties. Education facilities are provided on-site by the organisation for some young people.

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Inspection date Inspection type Inspection judgement

06/01/2014 Interim satisfactory progress 11/09/2013 Full good 08/01/2013 Interim inadequate progress 20/07/2012 Full good

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Statutory Requirements

This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Children's Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that a record in the form of a register is maintained showing the address prior to moving to the home, the address on leaving the home and the statutory provision under which a young person is accommodated. (Regulation 29(1) schedule 4(c)(d)(f)) 26/12/2014

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Recommendations

To improve the quality and standards of care further the service should take 5 of 12 account of the following recommendation(s):

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Recommendations

 ensure that risk assessments of the children's home environment are regularly reviewed (NMS 10.8)  ensure that action is taken to address any issues of concern that are identified within the written reports from the Regulation 33 visitor each month (NMS 21.9)  ensure monitoring is undertaken of all records kept by the home, to identify any concerns about specific incidents and identify patterns and trends. Immediate action is taken to address any issues raised by this monitoring. This is with specific reference to any incidents of bullying (NMS21.2)  ensure that a clear and comprehensive summary of any allegations made against a particular member of staff, including details of how the allegation was followed up and resolved, a record of any action taken and the decisions reached, is kept on the person's confidential file and a copy is provided to the person as soon as the investigation is concluded. (NMS

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Outcomes for children and young people outstanding

Young people make excellent progress in relation to their self-confidence and develop increased emotional resilience during their time living in this home. From their starting points, young people make significant progress in their knowledge and understanding of their backgrounds.

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Outcomes for children and young people outstanding

One placing social worker stated ' I cannot believe the improvements made by the young person since moving to this home. They now manage their behaviours so much better and have real empathy for others. I would not have believed that this was possible, given their background'.

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Outcomes for children and young people outstanding

Staff ensure that young people have all of their holistic health needs met to a very high standard. Some young people had previously not engaged with dental services. Since moving to this home, they have engaged with orthodontist services and significantly improved their oral hygiene. Other young people have worked with staff to consider and address their addiction to nicotine and reduced their smoking. Young people have access to psychological and psychiatric support and make significant progress in relation to their emotional and psychological health.

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Outcomes for children and young people outstanding

All young people living in this home have educational provision in place and attend every day. Some young people have progressed to attending local colleges and are studying for vocational qualifications. Other young people have previously had exceptionally poor engagement and attendance in education. Since moving to this home, their attendance has improved significantly and they have attained formal or vocational qualifications.

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Outcomes for children and young people outstanding

Young people learn the value of education and begin to set goals and have aspirations for their futures. The home has a proven track record of supporting and enabling young people to move on to further education and secure employment. Young people leave this home with the skills and confidence needed to make a valuable contribution to society and to secure employment. Part of the on-site education provision includes young people learning woodwork skills. They have made items of furniture such as wardrobes and coffee tables, which they have in their bedrooms. One young person stated 'I had never done anything like this before I moved here. I am very proud of what I made'.

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Outcomes for children and young people outstanding

Young people report feeling very well integrated into the local community. They take part in local events, hold yard sales at the home and attend local churches and youth clubs. The staff and young people also put on an external light display outside the home each Christmas. Local people and children from the primary school look forward to this and visit the home. This increases the sense of value for young people and of their active involvement with the local community. 7 of 12 Young people have regular direct and indirect contact with their family and others that are important to them. The staff team is very proactive in ensuring that contact is promoted and supported at all times. Young people report high levels of satisfaction in how their contact with family members and others is facilitated and supported by the staff team. Young people feel that their need for contact is always supported and that staff go out of their way to make sure that this takes place for

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Outcomes for children and young people outstanding

Young people have enjoyed holidays abroad with staff this year. They take part in a wide range of physical activities throughout the year. This has included a 'mini- Ironman' event, walking, cycling and canoeing trips. A strong focus is placed on the value of physical activities within this home. Young people enjoy learning new things, challenging themselves and spending quality time with the staff team and managers.

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Outcomes for children and young people outstanding

Young people learn a wide range of practical skills, which assist them in making a successful transition to adult life. Education programmes focus on vocational and practical skills for young people as well as formal qualifications. Young people learn how to budget and manage their own money. They assist staff in food shopping and meal preparation. Staff work with them on understanding how to apply for accommodation and in using public transport unaided. Some young people have been supported to learn to drive and have their own vehicles.

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Outcomes for children and young people outstanding

Young people who previously engaged in offending behaviours have made significant improvements. One youth offending worker praised the staff team for their excellent multi-agency working and support to young people. The worker stated 'this is by far, one of the best homes I work with. They really support and engage young people to address their offending behaviours over time'. The staff team were also praised for not further criminalising young people, by calling the police to the home unless absolutely necessary. Staff help young people to learn how to manage any concerning behaviours, leading to a significant reduction in criminal activities.

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Quality of care good

Young people state that staff really care about them and keep them safe. One young person reported that they had lived in several residential and foster placements before moving to this home. They reported that 'this is the best home by far I have lived in. This is because the staff really care about me and want the best for me all the time'.

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Quality of care good

Staff know the young people extremely well and how to respond to their complex needs. Placement plans for each young person provide a detailed insight into their needs and how these will be met. Staff diligently complete direct work with young people on a range of areas and record progress made over time. Young people respond well to this approach and make improvements in all aspects of their lives. 8 of 12 This has also led to very successful transitions to adult life for several young people.

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Quality of care good

Young people have educational provision in place to meet their specific needs. Staff work very proactively with other agencies to ensure the educational needs of all young people are met. An independent reviewing officer (IRO) praised the staff team for working tirelessly to ensure that one young person had the most suitable education provision in place. Staff were praised by the IRO for attending all relevant meetings and reviews, preparing well and advocating on behalf of the young person.

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Quality of care good

Staff demonstrate a very detailed knowledge of the diverse needs of each young person and meet those needs very well. Young people have been supported to attend local churches, to purchase special dietary items and to maintain cultural links with family and friends. Social workers from two placing authorities spoke very highly of the staff team and their work with young people. One placing social worker stated 'I cannot believe the positive changes for my young person. Previous placements had not been able to keep them safe. This home has enabled them to develop emotional resilience and empathy. They are a different child to the one I knew before'.

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Quality of care good

Young people feel included in all aspects of the care they receive. They confidently approach staff to make requests or suggestions. Staff ensure that they have opportunities and experiences which they may not have had before in their lives. This has included holidays abroad this year with staff from the home and on-site school. This not only provided some young people with their first experience of travelling abroad, but was also educational. Young people visited places of historic interest in France and Holland and speak with pride of what they saw and learned during the holiday.

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Keeping children and young people safe good

Young people report feeling very safe living in this home. Staff ensure that each young person receives the care and support necessary to ensure their safety. Involved agencies praise the staff team for ensuring the safety and well-being of young people at all times. Agencies report satisfaction at the quality and detail contained in individual risk assessments. They also report satisfaction at the good communication from the staff team.

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Keeping children and young people safe good

Each young person has an allocated key worker. They form a close and positive relationships with this person, as well as with other members of the staff team. This helps young people to feel safe and well-cared for. One young person stated 'the staff keep me safe in this home'.

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Keeping children and young people safe good

Staff fully understand the factors that may trigger young people going missing. Risk assessments reflect the specific needs of each young person and how staff should respond. There have been very few reported incidents of young people going missing from this home and numbers of unauthorised absences are low. The staff team 9 of 12 display a real ability to work with young people and rarely request the assistance of the local police in relation to any concerning behaviours. A youth offending service worker praised the staff team for their approach and success in reducing missing episodes and anti-social behaviour.

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Keeping children and young people safe good

Restraint is only used by the staff team when other de-escalation methods have not been successful. Suitably trained and experienced staff undertake restraints and records are maintained for each incident. Staff encourage young people to reflect on the use of restraint and to record their comments and sign each entry.

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Keeping children and young people safe good

Young people understand that bullying will not be tolerated in the home. Information is provided to them in the children's guide about the home's anti-bullying policy and use of sanctions. Risk assessments consider the potential for bullying or being the victim of bullying for each young person. Staff receive training in this area and report confidence in being able to identify and deal with any incidents. The Registered Manager does not yet have clear systems in place to monitor and identify patterns and trends in relation to bullying behaviours. This would further strengthen the work done by staff to eradicate such behaviours by young people.

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Keeping children and young people safe good

Staff display a detailed awareness and understanding of the diverse needs of each young person and respond to them very effectively. They ensure that full background information is gained for each young person and incorporate information into their placement plans. Such plans provide detailed evidence of how thoroughly staff work with young people to consider and address any concerning or potentially risky behaviours. This has led to a marked improvement for young people over time in relation to such behaviours.

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Keeping children and young people safe good

The recruitment and selection of staff is robust and prevents unsuitable people from working with vulnerable young people in this home. Allegations made against staff by young people have been considered and dealt with in a timely manner. The Registered Manager has ensured that all relevant professionals, including the local authority designated officer (LADO) have been notified. Electronic records of actions taken in relation to allegations have been maintained by the Registered Manager. These records have not been placed on the confidential file for relevant staff members. This has had no adverse impact on the safety or well-being of any young person.

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Leadership and management good

The Registered Manager has been in post for over five years and has the qualifications and skills necessary to perform the role. The two requirements and one recommendation from the previous inspection have been appropriately acted upon. Records of restraint now include signatures of relevant staff members. Risk assessments have been put in place for all activities young people take part in. Medication records have been updated to include details of any changes to 10 of 12 prescriptions and dosage for young people.

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Leadership and management good

A development plan in place for the home, setting out the plans for the coming year. The Statement of Purpose is clear and provides details of the services provided, aims and objectives of the service. Placing authorities report satisfaction at how well the home meets the aims and objectives of the Statement of Purpose for all young people placed at this home.

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Leadership and management good

Managers and all members of the staff team model a real commitment to meeting the diverse and complex needs of each young person living in the home. A key strength of the home is its focus on meeting the cultural and religious needs of young people. This includes the employment of staff from very diverse cultural backgrounds. This has enabled young people to be cared for by staff who can directly relate to their religious and cultural needs. Young people attend local churches, have their specific dietary needs met and maintain their sense of identity. For those young people whose first language is not English, this includes having staff who can communicate with them and their family members. Such attention to detail has greatly assisted some young people to form meaningful attachments to staff and feel secure. One agency praised the staff team for being able to tailor the care provided to one young person and their family members.

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Leadership and management good

The home is decorated and furnished to a very high standard internally and externally. Young people personalise their own bedrooms. They have made their own furniture and take great pride in this. One young person stated;' I am very proud of the wardrobe I made, I will take it with me when I move on'. Their bedrooms are large and spacious and include areas for study with comfortable seating areas in each room. Young people report high levels of satisfaction in their rooms and other areas of the home. They take pride in their home and ensuring that it is well maintained.

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Leadership and management good

A very stable staff team is in place with low turnover of staff in recent years. One new member of staff stated how much they enjoyed working in this home. They reported having an excellent induction, support from peers and training to meet their needs. Staff rotas ensure consistency of care for all young people throughout each week. Weekly handover meetings take place between staff, to ensure that relevant information is shared between staff going off shift and those starting.

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Leadership and management good

Placement plans for young people set out clear objectives for how their individual needs will be met. Regular updates of such plans takes place by the staff team. This provides clear evidence of the improvements made for young people in relation to their outcomes. Records relating to young people's care provide a clear and coherent sense of work done by the staff team. They would provide real meaning and value to young people, if they were to access their records now or in the future.

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Leadership and management good

There have been no reported concerns or complaints raised by young people or others for several years. The Registered Manager maintains positive relationships with local neighbours and ensures that any low-level issues are considered and 11 of 12 addressed in a very timely manner. The staff are very proactive and maintain positive relationships with the local community.

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Leadership and management good

The staff team attend all relevant meetings and looked after children's reviews. They take their own notes during reviews which are placed on the young person's files. This ensures that there is no delay in staff taking any necessary action, pending receipt of official minutes.

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Leadership and management good

A range of environmental risk assessments are in place for the home. These relate to cleaning and other products used by staff in the home. Several risk assessments have not been reviewed or updated within the specified timescales and present as very out-of-date.

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Leadership and management good

An independent person visits the home every month to undertake checks and to meet with young people. Reports are detailed and reflect full consideration of all aspects of how the home is run. The visitor consults with parents, young people and placing authorities to elicit their feedback on the services provided. The Registered Manager considers the monthly reports and takes any necessary action, but has failed to consistently record his responses to recommendations from the monthly visits.

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Leadership and management good

The admissions and discharge register for the home does not currently contain all required information. This relates to recording the legal status of each young person, their address prior to moving to the home and their address on leaving the home. This shortfall has not had an adverse impact at any level on young people. 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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