Children's Home run by Action for Children in Northumberland

Unique reference number SC000673 Inspector Nicholas Murphy Type of inspection Full Provision subtype Children's home

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Registered person Action for Children Registered person address Action for Children 3 The Boulevard, Ascot Road WATFORD WD18 8AG Responsible individual Julie Longworth Registered manager Roseanne Montague Date of last inspection 05/02/2014 2 of 10 Inspection date 14/01/2015

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Previous inspection good progress Enforcement action since last inspection there has been no enforcement action since the last inspection

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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

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Overall effectiveness

The home provides a satisfactory level of care both for children who live here and for those who attend for short breaks. Staff enable children to make choices and express their views. Staff have a good understanding of the individual needs of children and promote their happiness and well-being. Some written plans and records do not reflect the quality of work that staff undertake. There is some inconsistency in updating children’s case files. This makes it difficult to accurately assess the quality of their outcomes, although in general children make progress in relation to their starting points.

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Overall effectiveness

Children have good relationships with staff. They enjoy seeing familiar faces and benefit from the consistency and routine which the home offers. However, due to staffing shortages, substantial use of agency staff has been necessary in order to maintain safe levels of supervision. This has had a negative impact upon the experience of children. The extreme challenges presented by some children have also meant that others have not had the level of individual attention they need.

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Overall effectiveness

Staff have good skills in dealing with challenging and at times violent behaviour. Although there has been a very high level of restraints, these are appropriate and necessary to keep children and adults safe. The home has good links with 3 of 10 safeguarding agencies and reports any concerns promptly.

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Overall effectiveness

A number of statutory requirements and recommendations have been made. These are in relation to shortfalls which do not place children at risk but which must be addressed if the home is to provide a good service. Nevertheless, there is evidence that the home does have capacity to improve. 4 of 10

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Information about this children’s home

The home provides care and accommodation for children who have learning disabilities. There are five permanent places and five places for children who receive short breaks. The home is operated by a national voluntary organisation.

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Inspection date Inspection type Inspection judgement

05/02/2014 Interim good progress 03/07/2013 Full good 07/02/2013 Interim good progress 17/10/2012 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) promote and make proper provision for the welfare of children, specifically that each child has a detailed placement plan which is kept updated and is focused on clear measurable goals and outcomes (Regulation 11.1.(a)) 27/02/2015

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Reg. Requirement Due date

(2001) when conducting a review for the purposes of paragraph (1A(b)), (ensuring that the premises are appropriately and suitably located), consult and take into account the views of such local bodies or persons as the registered person thinks appropriate (Regulation 31(1B)) 27/02/2015

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Reg. Requirement Due date

5 (2001) keep under review and, where appropriate, revise 27/02/2015 5 of 10 the Statement of Purpose and notify HMCI of any such revision within 28 days (Regulation 5(a) and (b))

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Reg. Requirement Due date

(2001) establish and maintain a system for monitoring the matters set out in Schedule 6 at least once in every 3 months, supply to HMCI a report in respect of any such review, and ensure that it provides for consultation with children accommodated in the home, their parents and placing authorities (Regulation 34(1, 2 and 3)) 27/02/2015

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Reg. Requirement Due date

(2001) keep a record in the form of a register showing in respect of each child accommodated in a children’s home all the required information. (Regulation 29(1) Schedule 4(1)(a) to (f)) 27/02/2015

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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 that children’s health is promoted in accordance with their placement plan and the policy of the home, specifically that the written consent of parents is obtained for the administration of first aid and non- prescription medication (Volume 5, statutory guidance, para 2.54)  ensure that no more than half the staff on duty at any one time, by day or night, at the home are to be from an external agency (NMS 17.8)  ensure that the records of staff supervision are signed by the supervisor and the member of staff at the end of the supervision. (NMS 19.5) 6 of 10

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Outcomes for children and young people adequate

Children enjoy sound health. They are happy to receive dental and optical check-ups and cooperate with regular health assessments. Some have developed an awareness of what makes for a healthy lifestyle. For example, two children have just commenced weekly attendance at a fitness class in the area. With the support of staff, children have improved their ability to take responsibility for some of their own personal care tasks, such as brushing teeth.

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Outcomes for children and young people adequate

Children have good school attendance. Some have made significant improvement in this regard since coming to live here. In addition, schools report that most children are making progress, social as well as academic. One end of term report said of a child, ‘They are eager to attend school, have made friends, and take part in after school clubs.’

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Outcomes for children and young people adequate

With encouragement, some children like helping out in the home. Some will wash their own dishes after meals, and even do those of staff and other children if asked. One child told the inspector about some scones she had made, listing the ingredients and how she had mixed them. This kind of activity bodes well for the future, meaning that children will derive pleasure from doing things for themselves and contributing to their independence.

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Outcomes for children and young people adequate

Children have contact with family and others in accordance with their care plans. For some children, due to their family history, this can be difficult and upsetting at the time. Nevertheless, maintaining these links keeps children in touch with their backgrounds and gives them emotional comfort.

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Quality of care adequate

In the main, children get along well with staff. They enjoy their company and particularly like individual attention. One child said, ‘I like it here, I am happy.’ Children behave well, although sometimes their lack of understanding of appropriate social interaction causes distress for others. In particular, some young people’s behaviour requires a level of staff intervention which reduces the time they can devote to other children.

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Quality of care adequate

Staff strive to give children as much choice as possible. This includes not only day to day decisions, such as about meals and leisure activities, but also their living space. For example, children have chosen the colour of new furniture and carpets. If children have any worries or grumbles, they can make use of the complaints procedure. Although rarely used, each complaint receives a full response from the 7 of 10 Registered Manager, invariably to the child’s satisfaction.

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Quality of care adequate

Staff maintain care plans for each child but these are of variable quality. There is a system for setting out targets and goals which staff help children to work towards. Some children’s files contain evidence that these goals are monitored and reviewed, with successes celebrated. Others have no information at all in these areas, meaning that children are not set challenging milestones to help them develop. Staff keep running record books on each child which contain notes of their daily behaviour, incidents and so on. However, these are not always collated in a way which enables staff to assess progress and outcomes over the longer term.

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Quality of care adequate

Staff promote children’s health by liaising with health professionals and following each child’s health plan. Again, some plans and monitoring records are not updated at sufficiently frequent intervals. For example, the record of one child whose eating pattern was being monitored had the last entry some five months ago. Medication arrangements are robust and safe. However, not all children have written consent from a person with parental responsibility to administer non-prescribed medication or first-aid.

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Quality of care adequate

Staff have a positive attitude towards education and they communicate this to the children. Staff ensure that children are up in good time and well prepared for the school day. There is good communication between the home and schools, ensuring that issues in either setting can be addressed and managed.

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Quality of care adequate

Children are able to undertake a range of activities. They enjoy in-house recreation, like arts and crafts, or playing on games consoles. In addition, they take part in activities within the community. There are nearby leisure facilities which children can walk to with staff. Shopping for provisions is popular. These outings are not only enjoyable in themselves but also ensure that children remain connected to the wider community.

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Quality of care adequate

The home is very attractive, welcoming and well-maintained. It has specialist equipment so that children with severe disabilities which affect their mobility can be cared for in comfort and safety. Children are encouraged to have their bedrooms looking the way that they want. This gives them comfort and emotional security. One child has their own fish tank complete with four fish. It is clear that children who live here have developed a clear sense of belonging.

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Keeping children and young people safe adequate

Because most children are extremely vulnerable, the home ensures that there is sufficient staff on duty at all times to meet their needs and keep them safe. One consequence of this is that children do not have the opportunity to go missing. Staff have a good awareness of their responsibilities in reporting any concerns. They have recently had some training from the local authority designated officer for 8 of 10 safeguarding to refresh their knowledge in this area.

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Keeping children and young people safe adequate

The home has a strong and visible culture of anti-bullying which promotes cooperation and kindness between children. For most of the time this is successful in creating a harmonious community. However, there have been incidents where children have been hurt by others. This is because some children’s behaviour is unpredictable and sometimes aggressive. They are unable to consider the needs of others and behave appropriately in a group.

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Keeping children and young people safe adequate

Children have individual plans which provide detailed guidance for staff on what might trigger challenging behaviour and what strategies work in de-escalating it. Because of the scale and frequency of some children’s violent outbursts, some of these plans are extremely detailed. For example, for one child, staff prepared an extensive plan for how to manage the lead up to Christmas and the actual day itself. This was so as not to over stimulate the child and create the possibility of them losing control. There is also close liaison with other professionals and consultants in how best to deal with this aggression, with one particular child being the subject of numerous multi-agency meetings. Despite this investment of time and effort, staff have frequently had to use physical restraint to keep children and themselves safe. The staff are to be commended for their patience, tolerance and understanding in

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Keeping children and young people safe adequate

managing these situations, even though they themselves have suffered injury.

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Keeping children and young people safe adequate

There has been a recent recruitment drive with a number of new staff being appointed. The selection and vetting of these staff has been robust, giving assurance that they are suitable to work with children. Systems within the home to manage risk, such as the arrangements for fire safety, are good. The Registered Manager has completed an assessment of the home’s location as required by regulation. However, local agencies such as the police or the local children’s safeguarding board have not been consulted. This means that the home cannot take into account information about risks in the locality which might be held by these agencies.

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Leadership and management adequate

The Registered Manager has been in post since 2007, and is suitably experienced and qualified. All staff either have the appropriate qualification or are enrolled on it. The home’s Statement of Purpose accurately describes the services offered and the objectives it intends to achieve for children. However, it has not been updated to include details of newly recruited staff, nor has it been provided to Ofsted. This means that neither people who may use the service, nor the regulator, can know the composition, skills, and experience of the staff group.

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Leadership and management adequate

External monitoring of the home through monthly visits is sound and provides important independent scrutiny of the home’s operation. The Registered Manager’s own monitoring covers most required areas, although it does not take account of any consultation with children’s social workers. This restricts the ability of the service to 9 of 10 make improvements as a result of the views of those who place children here.

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Leadership and management adequate

The home has experienced difficulty in recruiting permanent staff to fill vacancies. In order to maintain the required staffing ratio, agency staff have been used on a regular basis and continue to be so. At times, there have been more agency than permanent staff on duty in the long term unit. The Registered Manager has always ensured that the number of staff on duty is sufficient to keep children safe. But, the use of workers who are not permanent does not best meet the emotional needs of children, in particular those with learning disabilities. They need stability and familiarity and do not cope well with a large number of different adults who come in and out of their lives.

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Leadership and management adequate

Staff receive a good level of training to maintain and refresh their skills. The Registered Manager evaluates the training needs of staff to ensure that they are equipped with the knowledge they require to support children effectively. Formal supervision of staff takes place regularly, but records of these sessions are not always signed. This reduces the accountability of both supervisee and supervisor for the accuracy of the record.

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Leadership and management adequate

Most records are kept in accordance with regulation and guidance. However, the children’s register of admissions and discharges does not contain all the required information. This is important if at any time in the future anyone needs to refer to it.

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Leadership and management adequate

Requirements and recommendations from the previous inspection have been addressed in full. This has improved accountability for the use of sanctions and ensured that children’s risk assessments cover activities inside and outside the home. Website: www.ofsted.gov.uk

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Leadership and management adequate

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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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