Children's Home run by One To One Crisis Intervention Ltd in Devon

Unique reference number SC003897 Inspector Sharron Escott Type of inspection Full Provision subtype Children's home

p.1

Registered person One to One Crisis Intervention Limited Registered person address 5 Newton Road Kingsteignton Newton Abbot Devon TQ12 3AL Responsible individual Annie Westbrook Registered manager Richard Antony Patterson Date of last inspection 11/03/2014 2 of 10 Inspection date 10/12/2014

p.1

Previous inspection satisfactory progress Enforcement action since last inspection none

p.2

Overall effectiveness adequate

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

p.2

Overall effectiveness

This inspection has identified significant shortfalls within the home's documentation. The manager’s enhanced working responsibilities have resulted in him having ineffective oversight and management of the home. The manager recognises this is affecting the effective leadership of this home and has taken immediate action to rectify this situation. The Registered Manager’s schedule has been reviewed to reduce his current workload so he can be in day-to-day charge of the home and take immediate action to improve the standard of the records pertaining to the young people the development of the home.

p.2

Overall effectiveness

Monitoring of the home is not wholly effective. The independent visitor has failed to identify and address several recording shortfalls. Among these shortfalls, records of physical restraint lack sufficient detail; the register of children placed is incomplete; and records of staff supervision are poor. A development plan is in place, however, it does not identify how further improvements will be achieved.

p.2

Overall effectiveness

There are no immediate concerns that young people accessing this service are at risk of harm or neglect. Young people are happy and relaxed living at this home and benefit from being looked after by committed and motivated staff, who provide warm, sensitive and considerate care. 3 of 10 There are areas of good practice and strengths in the service and as a result, young people are safeguarded from harm and achieve positive outcomes from their starting point’s. Written feedback from the Independent Reviewing Officer states; ‘The young person has a strong, capable and resilient team around them. The team understand young people’s needs and work closely with other agencies to ensure young people receive the support they need’.

p.2

Overall effectiveness

The manager has made improvements in practice since the previous inspection; young people are now looked after by a dedicated team of six staff. The team have attended specialist training which has informed them how to manage and meet the changing needs of young people in placement. This is reflected in the progress young people have achieved since being placed at the home. 4 of 10

p.3

Information about this children’s home

This service is operated by an independent organisation. Children and young people using this service may have emotional or behavioural difficulties. The service is registered to provide residential care and accommodation for one child or young person.

p.4

Inspection date Inspection type Inspection judgement

11/03/2014 Interim satisfactory progress 27/01/2014 Full adequate 30/10/2013 Full inadequate 20/11/2012 Interim good progress

p.4

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.

p.4

Reg. Requirement Due date

(2001) ensure that a record in permanent form is maintained in respect of each child who is accommodated in a children's home, which includes the information, documents and records specified in Schedule 3 relating to that child, is kept up to date, and is signed by the author of each written entry (Regulation 28 1(a)(b)(c)) 30/01/2015

p.4

Reg. Requirement Due date

(2001) maintain in the children's home the records specified in Schedule 4 and ensure they are kept up to date (Regulation 29 (1)) 30/01/2015

p.4

Reg. Requirement Due date

31 ensure that all parts of the children’s home used by 30/01/2015 5 of 10 (2001) children are kept clean and reasonably decorated and maintained (Regulation 31 (2)(e))

p.4

Reg. Requirement Due date

(2001) maintain a system for robustly monitoring the matters in Schedule 6 in order to improve the quality of care. In addition, ensure that there is effective analysis and documented evidence, of the trends and patterns of behaviour management in order to inform future practice. (Regulation 34 (1)(a)(b)) 30/01/2015

p.5

Recommendations

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

p.5

Recommendations

 ensure a written development plan, reviewed annually, for the future of the home details any planned changes in the operation or resources of the service, or confirms the continuation of the home's current operation and resources (NMS 15.2)  ensure there is an effective system in place to monitor the quality and adequacy of record keeping and take action when needed (NMS 22.1)  ensure entries in records are legible, clearly expressed, non-stigmatising and distinguish as far as possible between fact and opinion. (NMS 22.4) 6 of 10

p.5

Outcomes for children and young people adequate

Outcomes for young people are variable. Young people are provided with continuity of care by a staff team who ensure young people's daily living needs and well-being are promoted. Care staff understand, show tolerance and respond to individuals’ diverse and complex needs. They encourage young people to take some responsibility for their own welfare and to make safe choices.

p.6

Outcomes for children and young people adequate

Young people attend their routine medical checks and sustain good health. In addition, young people are supported to access specialist health services. They attend weekly appointments with Child and Adolescent Mental Health Services (CAMHS). These weekly sessions enable young people to explore and apply alternative strategies to manage their anxieties and reduce risk-taking behaviours.

p.6

Outcomes for children and young people adequate

The home's records indicate that in recent months young people have presented high risk and aggressive behaviours towards staff members. Three incidents have resulted in staff injury and police intervention. The manager has reviewed all risk assessments, and has been successful in securing authorisation from the local authority to increase staff levels until risk-taking behaviours have reduced.

p.6

Outcomes for children and young people adequate

Young people’s further education arrangements have changed because of current risk taking behaviours. Young people say they are not happy with this change, but they understand why, and are pleased that they are still able to attend performing arts club at the weekend.

p.6

Outcomes for children and young people adequate

The views of young people were obtained during the inspection: they enjoy living at the home and personally rate the quality of care they receive as good. They said they felt safe and enjoy spending time with some staff members.

p.6

Outcomes for children and young people adequate

Young people’s achievements are recognised and celebrated. Certificates are proudly displayed on the walls in the living room. This contributes to young people feeling valued and encourages a sense of belonging.

p.6

Quality of care adequate

Staff work well in partnership with other agencies, family members and significant others to promote positive outcomes for young people. However, progress for young people fluctuates. Family members and professionals are generally satisfied with the quality of care provided to young people living in this home. A social worker noted that the staff team had worked hard to understand and meet the young person’s needs. 7 of 10 The care team focus on developing positive and respectful relationships with young people. These relationships and the organisation’s therapeutic parenting model underpin the culture and ethos of the home. Staff utilise these to good effect in encouraging socially acceptable behaviour and challenging inappropriate behaviour in a calm, patient and caring manner. Young people’s daily living routines are structured and well thought out which helps bring stability to their lives. Young people say they

p.6

Quality of care adequate

feel safe at this home and confidently express their feelings and emotions. This means young people are gradually developing better coping strategies to manage their anxieties, frustrations and unpredictable behaviour.

p.7

Quality of care adequate

Individual sessions with staff help young people to gain some understanding of their achievements, current needs and future aspirations. Staff recognise and respect young people’s individuality. High staffing levels are provided and give young people quality time with their carers which helps them to reflect upon their past. Young people are encouraged to think about their behaviour and the impact this has on their well-being and future opportunities. However, the quality of records pertaining to the achievements made and direct work provided is variable. The impact and value of one to one and supervision sessions is not clearly evaluated within the home’s monitoring processes.

p.7

Quality of care adequate

Staff encourage young people to make the house ‘their home’ and they can personalise rooms to their preferred taste. However, the staff have not been successful in assisting young people to maintain their bedroom to an acceptable standard. For example, clothing was stored on the floor as a result of the hanging facilities being broken.

p.7

Keeping children and young people safe adequate

The home works collaboratively and effectively with other agencies to ensure young people are protected. Staff demonstrate a sufficient understanding of safeguarding issues and work within local protocols to ensure young people’s safety is a priority. Staff complete mandatory safeguarding training and have benefited from attending additional specialist training in self-harm, child sexual exploitation and attachment.

p.7

Keeping children and young people safe adequate

Generally, the staff’s approach to managing challenging behaviour is creative. Sanctions are not used; as an alternative the team focus on restorative work in response to any unwanted or unacceptable behaviour. This approach helps young people understand the consequences of their actions. Physical intervention has been used to safeguard young people and others from harm. Records inform that staff have intervened on nine occasions, and these interventions have been appropriate and in response to high risk-taking behaviours.

p.7

Keeping children and young people safe adequate

Young people do not take advantage of the home's incentive scheme which provides opportunities for young people to increase their pocket money. Incentives are linked 8 of 10 to household cleaning chores. Young people are not enthused or motivated to earn additional money in this way. This means young people’s positive contribution within the home is limited and incentives current used do not encourage young people to make positive changes in their behaviour and learn new skills.

p.7

Keeping children and young people safe adequate

Staff members are provided with guidance in what action to take in the event young people go missing from the home. Individualised protocols, which are agreed and approved by the police are in place. Records show that young people have been missing from the home on six occasions. However, documents maintained do not demonstrate actions taken by the staff to encourage young people to return to the home or to ensure their safety. Several sections of these records were incomplete.

p.8

Keeping children and young people safe adequate

Procedures for the recruitment of staff are good. Suitable checks are completed on all potential staff prior to them being in direct contact with young people. Visitors to the home are required to show proof of identity, sign the visitors’ book, and are appropriately supervised throughout the visit. As a result, young people are protected from persons who may pose them harm.

p.8

Leadership and management adequate

The manager has been registered with Ofsted for a year. The Registered Manager is also responsible for the leadership of another home and provides behaviour management training for care staff within the wider organisation. As a result, his availability to be in day-to-day charge of the home has been restricted. However, the Registered Manager and responsible individual have recently reviewed and reduced the managers working responsibilities. As such, he now has sufficient capacity to manage and provide effective oversight of the quality of care provided in this home.

p.8

Leadership and management adequate

The responsible individual and Registered Manager have expressed a firm commitment to improving deficiencies with the documents that are managed and maintained by the home. As such, a full review of the home’s records is currently underway, the introduction of new care and behaviour management plans have been approved and are pending implementation. In addition, the home’s development plan will set out clear and realistic goals for development and improvement.

p.8

Leadership and management adequate

Significant steps have been made to ensure young people are provided with continuity of care from a dedicated, trained and experienced staff team. Young people benefit from being cared for by a suitable number of qualified, experienced and motivated staff. A rota is in place for core staff; however the manager’s working arrangements are not recorded on this document which means staff are not always aware of his whereabouts. As a result, the care team are reliant at times on telephone communication to gain support and guidance. This has not had any detrimental impact on the care of young people.

p.8

Leadership and management adequate

The Registered Manager has failed to identify several shortfalls in records. Monitoring 9 of 10 processes are ineffective in checking the accuracy and quality of records. As such, errors and omissions in records are not promptly identified and rectified. In addition, the register of young people residing at the home does not provide sufficient detail in relation to young people’s forwarding contact details and the home’s support for effective transition planning.

p.8

Leadership and management adequate

A new independent visitor has been appointed. He is assisting the organisation in developing new monitoring systems. The manager stated that he is confident that the appointment of the new independent visitor will ensure visits are completed within the required timescales and the reports will provide him with support in addressing deficiencies within the home’s records. The impact of this provision is yet to be determined.

p.9

Leadership and management adequate

Regular team meetings are held and provide staff with support and opportunities to openly discuss concerns, and consider how to manage young people's needs. The manager and staff team receive regular supervision; however, records of these meetings vary in quality. For example; discussions about performance issues and reflective practice are not documented. This limits the opportunity for individuals’ to improve their practice and quality of care they provide.

p.9

Leadership and management adequate

All staff complete induction and mandatory training which is refreshed regularly. This learning is contributing to their professional development and informs them on how to respond to and manage young people's complex needs and behaviours. Website: www.ofsted.gov.uk

p.9

Leadership and management adequate

This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

p.10

Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

p.10

Judgement Description

Good A service of high quality that exceeds minimum requirements.

p.10

Judgement Description

Adequate A service that only meets minimum requirements.

p.10

Judgement Description

Inadequate A service that does not meet minimum requirements.

p.10

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.

p.10

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.

p.10