Children's home run by Roseberry Specialist Care Centres Ltd in Sunderland

Unique reference number SC430002 Inspector Michele Hargan Type of inspection Full Provision subtype Children's home

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Registered person Roseberry Specialist Care Centres Ltd Registered person address 2 Defender Court Sunderland Enterprise Park SUNDERLAND SR5 3PE Responsible individual Ronald Michael McNamara Registered manager Sarah Louise Appleton / POST VACANT Date of last inspection 11/02/2013 2 of 11 Inspection date 25/03/2015

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Previous inspection good progress Enforcement action since last inspection At the last inspection 11 requirements and 10 recommendations were made.

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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

Outcomes for young people are improved from the previous inspection. Better consultation with young people ascertains their views, thoughts and wishes. This values young people. Relationships with staff are good. This enables young people to form positive bonds with the adults who care for them. Changes in the behaviour management policy improves guidance to staff and promotes consistency for young people regarding rewards and incentives. Positive behaviour management increases young people’s self-confidence.

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Overall effectiveness

Better inter-agency working is benefiting young people and their outcomes. Good joint-working with schools has improved continuity of care at times of transition. This promotes increased attainment and builds young people’s self-esteem. Contact arrangements are good. This ensures young people maintain links to people who are important to them. This provides young people with emotional security. Young people’s records contain all required information. In addition, independent sources of support to young people are available and new child-friendly documentation aimed at eliciting their views is now in place. This gives young people a voice and increases understanding about their previous circumstances and histories.

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Overall effectiveness

The home have improved and progressed by meeting the requirements and all 3 of 11 except one recommendation from the last inspection. This shows a commitment by the registered provider to improve the service and outcomes for young people. Records have been updated to ensure the home’s efficiency. The Statement of Purpose fully reflects how staff use technology when in the best interest of young people and with the appropriate consents. The children’s guide better informs young people about external sources of help, including how to contact their independent reviewing officer. This promotes safe care practice and respects the rights of young people.

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Overall effectiveness

Medication systems are significantly improved, including staff’s understanding of how to manage controlled medication. A designated person is responsible for administering medication, and daily audits of medication take place. This ensures the safety and wellbeing of young people and promotes the accountability of staff. The recording of restraints and disciplinary measures is more robust. This provides for effective monitoring. The behaviour management policy now better includes guidance relating to managing the behaviour of disabled young people. This increases positive behaviour management. Risk assessments detail actions aimed at collaborative working aimed at keeping young people safe. Some young people’s participation in fire drills is not clear, placing them at increased disadvantage in the event of a real emergency. A recommendation is made to address this.

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Overall effectiveness

The registered provider has a better understanding of the legislation to notify statutory agencies and Ofsted of significant events. This enables social workers, and Ofsted, to monitor the home and the welfare of young people. An independent person now carries out visits to scrutinise running of the home and the quality of care available to young people. This ensures the registered provider complies with the legislation governing children’s homes. Equally important, this also promotes improvements in care practices and staff accountability.

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Overall effectiveness

The stability of the home is improved by having a manager who has applied to be registered with Ofsted. Improvements in safeguarding young people now includes better liaison with the local authority designated officer. This provides young people with an independent agency to ensure their welfare is promoted. Uncertainty about environmental safety is addressed as regular utility checks are carried out. Other improvements in the home, such as providing window coverings, promote young people’s privacy and dignity.

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Overall effectiveness

Policies and procedures are dated making clear timescales for review. A recommendation to provide the home’s development plan is not met and as result is raised within this report. An audit of staff recruitment files demonstrates suitability of staff. This promotes the safety of young people. The recruitment policy and procedure does not reflect that gaps in employment histories are explored, although this does take place in practice. As result of this omission, a recommendation is made. 4 of 11

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Information about this children’s home

This home is registered to offer care and accommodation for six children with autism and learning and physical disabilities. The home is operated by a private provider.

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Inspection date Inspection type Inspection judgement

10/09/2013 Interim good progress 22/05/2013 Full adequate 24/01/2013 Interim satisfactory progress 28/08/2012 Full adequate

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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 the home implements a proportionate approach to any risk assessment. In particular that risk assessments make clear the review date (NMS 4.5)  ensure there is an emergency escape plan that all staff and children are familiar with and have practiced so they know what to do in an emergency. In particular that each young person takes part in fire drills on a regular basis (NMS 10.9)  ensure 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 homes current operation and resource (NMS 15.2)  ensure the registered person can demonstrate, including form written and electronic records, that it consistently follows good recruitment practice, 5 of 11 and all applicable current statutory requirement and guidance in staff recruitment and carers’ selection. In particular that the recruitment policy

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Recommendations

and procedure reflects the current practice within the home to check gaps in employment histories of applicants (NMS 16.2)  ensure management of the home ensures that all staff's work is consistent with these Regulations and NMS, the homes policies and procedures. In particular staff sign to indicate they have read and understood the homes policies and procedures. (NMS 21.3) 6 of 11

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Outcomes for children and young people adequate

Young people receive good support that meets their individual needs, promoting their emotional resilience. For example, staff know how best to respond to young people whose physical health needs affect their mood and behaviour. The calm approach of staff at these times helps reduce young people’s anxieties and teaches them socially acceptable behaviour. A young person responded when asked about improvements he would like to see, ‘There is still nothing that I would change.’ An independent visitor who speaks with young people on a regular basis said, ‘I am proud that the children here are treated as individuals.’ This promotes positive equality and diversity.

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Outcomes for children and young people adequate

Staff encourage young people to improve their health and wellbeing through the use of a points system where young people are able to choose additional treats as their incentive. This raises young people’s awareness about healthy living and builds their self-esteem through recognition of their efforts. Working together with families is improved by keeping parents updated and involved with their children’s health and wellbeing. Effective communication promotes improved health related outcomes. A parent said, ‘Anyone will speak to us, we can go to the Registered Manger or the deputy, they take things on board now.’ Staff continue to care for young people at times of increased vulnerability such as during hospital stays. This promotes young people’s physical recovery and emotional wellbeing by maintaining consistency of care. This also provides practical support to parents by providing reassurance, helping

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Outcomes for children and young people adequate

reduce anxieties understandably raised at such times.

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Outcomes for children and young people adequate

Young people’s educational needs are met. Staff regularly liaise with education staff which helps establish a mutual understanding about how best to support young people. For example, good partnership working has improved managing difficult behaviour triggered within the home or school. Adopting this approach promotes consistency and eases young people’s anxieties, particularly at times of transition. A teacher said, ‘I like to think we are working closely together, whatever sort of day young people have here has a knock on effect and visa-versa.’ Effective joint working promotes young people’s educational attainment. A teacher said, ‘Young people’s attainment has gone up a number of sub-levels.’

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Outcomes for children and young people adequate

Young people’s contact arrangements are fully supported and enabled, and where contact is not possible, for whatever reason, this is explained to young people and their families. This ensures young people maintain positive links with people who are important to them. Visitors to the home are made welcome, which promotes positive contact. This means the young people’s place within their family is preserved, promoting the development of their identity. A parent said about the approach of staff, ‘We know that the staff have our child’s best interests at heart.’

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Outcomes for children and young people adequate

Young people are supported to make the transition into adulthood. Staff encourage young 7 of 11 people to take appropriate levels of responsibility, taking into account their skills and abilities. This helps prepare young people for independent living and promotes their rights to make choices. Young people also contribute towards their community by raising money for charity. This teaches empathy and consideration of others. A young person said, ‘I’m doing bag packing, it’s really good’, and a member of staff added, ‘It’s for Autism awareness week we’re doing it at the local supermarket.’

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Quality of care adequate

The administration of medication is improved. Staff have received training and follow the newly implemented medication policies and procedures for the safe recording, handling and administration of medication. This promotes young people’s welfare. A senior member of staff said, ‘I saw the pharmacist and a nurse, we have new consents from general practitioners, it’s a much better system.’ Another member of staff said, ‘We have to do a medication check at night, you can pick up on any discrepancies, but to be honest we haven’t had any.’ This improved practice promotes good outcomes for young people and the accountability of staff.

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Quality of care adequate

Staff take responsibility for establishing and maintaining meaningful relationships with children and with parents, helping address any concerns. This builds trust, restores relationships and builds confidence about the care young people receive. A parent said, ‘Things are more organised now, there is a planned approach, staff take things on board and we think our child is more settled.’ Creating a relaxed and harmonious atmosphere reduces anxious feelings that may otherwise lead to young people’s distressed behaviour.

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Quality of care adequate

Young people’s meetings regularly take place and staff actively canvass their views. This gives young people a voice in their care and the operation of the home. A staff member said, ‘We have a new suggestions box in the dining room, young people know it’s there if they don’t want to talk to us directly.’ This gives young people permission to offer constructive as well as positive feedback.

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Quality of care adequate

Staff know at what point to ensure young people have access to specialist healthcare agencies. For example, young people’s healthcare risk assessments make it clear when staff must take actions to involve child and adolescent mental health services, particularly when young people are experiencing psychological or behavioural difficulties. This promotes good, quality care while responding to the needs of vulnerable young people. There are some examples where healthcare risk assessments have been reviewed, however, the date of the next review is not recorded. This could allow for a review to lapse without young people’s needs being updated. A recommendation is made to address this.

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Quality of care adequate

The needs of learning disabled young people are now reflected within the home’s behaviour management policy. This promotes equality and diversity for all young people. These improvements have been drawn to the attention of staff, ensuring 8 of 11 staff responses to behaviour take into account the underlying needs of young people that may lead to challenging behaviours. This promotes safe care practice. A staff member said, ‘Some of the policies have changed, behaviour management has changed, you can see the improvements.’ Staff are better working with young people to involve them in their placement reviews. This helps young people understand why they live in a children’s home and how their care and welfare is promoted. This type of support empowers young people and respects their rights.

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Quality of care adequate

Young people live in a safe environment that meets their needs. Staff ensure the home is appropriately maintained, including certified annual checks to the oil fired central heating boiler. A window blind is now in place within the bathroom promoting young people’s right to privacy. Appropriate upkeep of the home values young people and promotes a sense of belonging. Support systems are improved as staff can now summon help by the provision of discreet personal alarms. This promotes the safety and wellbeing of young people and staff.

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Keeping children and young people safe adequate

Staff keep young people safe and young people’s behaviour demonstrates that they feel safe. For example, young people trust staff enough to show difficult feelings reaching a resolution that restores relationships. This promotes the development of empathy and models to young people how to resolve difficult feelings calmly. The registered provider has good links with local safeguarding agencies. This ensures consultation takes place with the local authority designated officer to address complaints about care practices. This demonstrates an approach that puts the needs of young people first when responding to such concerns. This action promotes the safety and wellbeing of young people and clarifies whether any further actions regarding staff need to happen. An outstanding complaint at the time of the last inspection is now addressed. The complainant said, ‘We have received an apology and the things we queried have been addressed.’ This response reassures those who

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Keeping children and young people safe adequate

complain that their concerns are not taken seriously.

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Keeping children and young people safe adequate

Good staffing levels and supervision reduces the risk of young people going missing. Should a young person leave the home unaccompanied there are good missing children procedures that are known by staff. This keeps vulnerable young people safe. The home operates a zero tolerance to bullying, which is effective. Young people know they can talk to staff if they feel bullied or threatened outside of the home. For example, at school, where young people are more informed about sources of help reducing anxieties about what to do at such times.

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Keeping children and young people safe adequate

Staff development plans includes advanced level training in responding to challenging behaviour. The behaviour management policy now takes into account the needs of learning disabled young people. This informs and advises staff of positive behaviour management strategies for young people who may not understand their behaviour or 9 of 11 how their behaviour impacts on others. This promotes tailored care practice and increases staff effectiveness with managing challenging behaviour. Physical restraints are used to manage behaviour, but only as a last resort. Staff know the reasons why restraints may be used in a children’s home, which ensures no young person is compromised. Incidents of restraint and sanctions are reviewed and analysed which is aimed at further reducing them and identifying any contributory factors. Not all young people take part in regular fire drills. Insufficient practice with emergency

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Keeping children and young people safe adequate

evacuation procedures disadvantages young people in the event of an actual emergency. This compromises young people’s safety. As a result, a recommendation is made to address this.

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Keeping children and young people safe adequate

Staff files are audited ensuring that good recruitment practices are followed. This demonstrates young people are cared for by staff who are suitable to do so. The manager said that since the previous inspection, ‘I have done online recruitment training, it was a good refresher.’ The manager addresses historical uncertainties from previous staff applications. This promotes confidence in recruitment practices. Policy and procedural guidance needs to reflect the home’s current practice with checking any gaps in employment histories. This is to ensure consistent recruitment practices remain in force for the safety and wellbeing of young people. A recommendation is made to address this.

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Leadership and management adequate

There is a new manager in post who has applied to be registered with Ofsted. This has strengthened leadership and management outcomes since the last inspection. The manager has experience working in the children’s home and has the right qualifications to carry on and manage children’s home. The registered provider has a better understanding of his responsibility to notify Ofsted of significant changes. This demonstrates an appropriate level of accountability as befits this individual’s level of responsibility. Moving towards a more stable management structure and improvements since the last inspection has considerably improved staff morale. This contributes to improvements in the quality of care and outcomes for young people.

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Leadership and management adequate

The Statement of Purpose makes clear when and why staff use equipment to monitor young people, and only do so to keep young people safe. Consents are sought from parents and social workers, which ensures young people’s privacy and dignity are maintained. The children’s guide now makes clear to young people external sources of help and support including Her Majesty’s Chief Inspector and names of their independent reviewing officer. This informs and empowers young people.

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Leadership and management adequate

Young people’s records now contain the information required by legislation making clear their experiences of care now and for future reference. Up to date and accurate record keeping promotes confidence in the management and care planning systems. Ofsted is notified appropriately in line with regulatory requirements of any significant concerns affecting the safety and welfare of young people. This affords Ofsted an appropriate opportunity to verify that the home has taken the necessary steps to 10 of 11 keep young people safe.

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Leadership and management adequate

The home does not have a development plan in place that identifies strengths and weaknesses or how the home intends to progress and improve. While assurances that a meaningful consultation with staff and the registered provider is to take place, the absence of a current plan creates uncertainty about how current improvements are to be sustained. A recommendation has been raised at this inspection.

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Leadership and management adequate

The current systems to ensure staff read and understand recently implemented policies and procedures are not rigorous enough. For example, there is no audit trail to demonstrate staff are familiar with any changes or new procedural guidance. This undermines management systems to keep staff up to date with good practice guidelines. A recommendation is made to address this.

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Leadership and management adequate

Robust systems are in place to demonstrate sufficient staff are on duty at all times. Staff explained the home’s electronic system that monitors staff attendance and ‘takes a photo of each person and the time you come on duty’. This system provides for good monitoring of staffing adequacy now and in the future. Effective electronic systems also aid financial administration and make it clear sufficient funds are available to meet young people’s needs. 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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