Children's home run by ROC Northwest Limited in Westmorland and Furness

Requires improvement

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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because:

 Staffing arrangements in the home do not provide for the highest standard of care. For example, 23 out of the 53 staff team have been in post for six months or less resulting in staff who do not know the young people well. Transient staffing over a period of time does not provide consistency and predictability for young people to develop trusting relationships. Furthermore, the majority of staff spoken to report staff turnover and tiring shift patterns as contributing to their low morale. In addition to this, a lack of regular quality supervision of staff means that the Registered Manager cannot be assured that all staff have the appropriate knowledge, competence and skills in delivering high quality care to young people.

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because:

 All staff working at the home do not have the knowledge and training to competently meet the needs of young people with specific and complex health needs. Also, monitoring and recordings of two young people’s health requirements are poor and incomplete. Consequently, the effectiveness of care practice cannot be fully assessed, nor can patterns or issues of concern be spotted. For example, triggers to identify patterns in weight loss or gain.

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because:

 Not all children receive personalised care that meets their individual needs in accordance with their culture and religion. Furthermore, the health care delivered by staff is not assured as no competence assessment by a trained professional has been completed.

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The children's home strengths

 Young people have made good progress in terms of engaging with activities, regularly attending school, regulating and managing their behaviours.

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The children's home strengths

 The staff members observed were dedicated to young people and demonstrated warmth and understanding towards them.

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The children's home strengths

 External monitoring reports are thorough and focus upon the improvement and development of the home.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

13. Leadership and management standard In order to meet the leadership and management standard the registered person must –

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Requirement Due date

(2)(b) ensure that the staff work as a team where appropriate; and (e) ensure that the home’s workforce provides continuity of care to each child (h) ensure that monitoring and review systems make continuous improvements in the quality of care provided; specifically ensure they are effective and improve communication and recording 18/09/2015

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Requirement Due date

6. The quality and purpose of care standard In order to meet the quality and purpose of care standard the registered person must –

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Requirement Due date

(2)(b)(iv) ensure that staff provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking into account their background; in particular their culture and religion

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Requirement Due date

(3)(c) ensure that care is delivered by a person who – (i) has experience, knowledge and skills to deliver that care and (ii) is under the supervision of a person who appropriately is skilled and qualified to supervise that care 18/09/2015

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Requirement Due date

10. Health and well-being standard In order to meet the health and well-being standard the registered person must –

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Requirement Due date

(1)(a) ensure that young people’s health needs are met; and (2)(a) that staff help each child to – (i) achieve the health outcome recorded in the relevant plans; 18/09/2015 and (ii) In particular improve staff recording and monitoring of young people’s diet and food intake

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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 the Statement of Purpose includes the home’s approach to delivering specific health care activities. (The Guide to the Quality Standards, page 18 paragraph 3.32)

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Information about this children's home

This section should outline: The home is registered to accommodate up to 15 young people with emotional and/or behavioural difficulties, physical or learning disabilities, mental disorders and sensory impairment. Both full-time and short break care is provided and there is a school on site.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

05/03/2015 CH - Interim sustained effectiveness

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Recent inspection history

07/02/2014 CH - Interim Satisfactory Progress

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requires improvement

Young people living at the home have disabilities and complex needs. They require consistency and predictability in their lives to navigate their environment successfully. Although new staff have been recruited, in part to increase staffing capacity in the home but also for other reasons that have required some staff to leave, never the less staffing arrangements have impeded the need for consistency with 23 out of the 53 staff team new to the home with limited experience of the young people; making trusting and consistent relationships difficult to forge . That said, there are staff who are part of the core team who demonstrate caring and affectionate relationships with young people and know them very well.

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requires improvement

A lot of young people make good progress from their starting points. They attend education and work experience opportunities regularly and have made real strides in regulating their behaviour. Partner agencies comment: ‘The school is excellent, he has made good progress.’ Staff support and encourage young people to access community facilities and engage in recreational pursuits, such as, swimming, trips to the park, discos, trampolening and shopping. However, staff report that the lack of staffing over time has prevented them from going out on activities with young people.

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requires improvement

Young people’s health outcomes are variable. Whilst all young people are registered with general medical practitioners and receive specialist consultancy where necessary, two young people, from the cases looked at during inspection, do not have their health needs fully monitored and recorded by staff in line with their care plans. Furthermore, not all staff have had training around young people’s specific needs. In particular, their competence in the delivery of gastrostomy health care to a young person has not been assessed or confirmed. Consequently, this young person’s optimum health care cannot be assured.

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requires improvement

Transitional planning arrangements are in place and support young people moving on to adult living. Endings are well planned and the needs and feelings of young people are placed at the centre of practice. Young people have moved on successfully and social workers report positive care practice informing these moves.

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requires improvement

The majority of young people experience care that is sensitive and responsive to their background, culture and faith belief. However, this is not the case for all of them as customs for two young people’s individual faith beliefs are not routinely adhered to, such as halal dietary requirements. This does not ensure respect and pride for young people’s personal beliefs. Partner agencies and survey feedback are again variable about the care and experience of young people. A professional commented: ’The home do very well with him, I am happy with the care and progress and he has come on so much.’ Another felt that care is ‘satisfactory’ and the staff are ‘ineffective’ and ‘lack motivation.’ These issues are being addressed but are indicative of differing staff practices within the home.

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good

The safety and protection of young people is central to staff practice. They are trained and understand how to safeguard young people. Additionally, they are able to articulate how abuse and neglect can impact upon young people, which enables them to identify and address any concerns appropriately.

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good

Whistleblowing processes are in place and have been used. Although, there has been a short delay in staff reporting safeguarding matters. Once alerted, the Registered Manager takes prompt action and works in partnership within the protective network of professionals, notifying the relevant bodies to promote and protect young people.

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good

Good risk management and review makes sure that risks are identified. Additionally, risk reducing measures are put in place to minimise potential areas of concern. Each young person has a range of risk assessments in place, identifying their needs and how they will be met. There are no incidents of them missing from home or involvement in risk taking behaviours such as, drug or alcohol misuse.

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good

Staff have developed strategies to manage young people’s behaviours and physical interventions are reducing. Also, consultation with young people’s families and partner agencies following restraints offers transparency in the behaviour management process.

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good

Young people live in a physically safe environment where they are protected by well managed health and safety procedures. Moreover, organisational procedures are in place to promote safer recruitment practice. Checks with the Disclosure and Barring Service and reference checks are undertaken before any appointment of staff is made. Again, staff are vigilant and take appropriate steps to verify visitor’s identity to promote their safety.

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requires improvement

The Registered Manager has been in post for approximately 18 months. She has the necessary skills, qualifications and experience of working with young people with disabilities. She is supported to run the home by a management team that includes deputy managers, floor managers and shift leaders. These staff also undertake a supervisory role for other staff working in the home.

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requires improvement

Despite a full management team, lines of reporting are not clear and information is not always shared between the management team to ensure the smooth running of the home. For example, investigations into staff practice have not been shared with the supervisor to improve the care practice of staff involved. Moreover, there is no evidence of a management review or learning from such significant events to inform and improve future care practice . Again, poor and inconsistent monitoring and record keeping, including daily records and health monitoring records, makes it difficult to assess the impact the home is having upon each young person’s life. Moreover, it fails to identify triggers or patterns in weight loss and weight gain.

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requires improvement

Leaders, managers and staff acknowledge this has been a difficult time and have worked hard to improve consistency of staff and their practice. For example, they have introduced incentives to boost moral such as a raffle and staff questionnaires. However, there is still some way to go. For example, quality supervision of staff is not taking place regularly to assure and monitor standards in care practice to vulnerable young people. This is in part due to supervisors having to cover shifts because of gaps in staffing. Furthermore, not all staff have completed thorough training specific to the needs of young people such as gastrostomy and epilepsy care. The lack of a consistent and competency assured staff team compromises the quality of care to young people. Moreover, these areas for improvement have not been identified by the manager to continually improve the experience and care of young people.

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requires improvement

One of the strengths of the home is that core staff persevere through difficult and challenging times and help young people to overcome the barriers they face. Despite low morale and tiredness of staff, the core team remains in place to support young people’s daily lives. For example, young people make good progress from their starting point, in that their behaviour has calmed and they are now able to engage in activities in the home and in the community. The Statement of Purpose has recently been updated and generally reflects the service provided. However, it does not include a full account of the approach to delivering gastrostomy care to young people. The premises are tired in areas and require further maintenance work to ensure high standards of accommodation for young people. This has been highlighted in the independent person’s report and is currently being addressed by the Registered Manager but was not addressed

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requires improvement

sufficiently well at the time of the inspection.

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requires improvement

There are variable reports from partner agencies some better than others. One stakeholder commented, ‘communication is good and they keep me up-to-date.‘ Others say ‘reports are poor quality and do not give a sense of the young person’s daily life, communication could be better.’ However, staff participate in care planning and contribute constructively to reviews and work well with young people and their families sharing information. At the last interim inspection one requirement and two recommendations were made about the staffing, training and gaining medical advice regarding restraints. Consistency and competence of staff and training have not been fully addressed and gaps remain, therefore these are repeated. Advice has been sought and health conditions are now taken into account to determine the risk of restraint with the young person.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

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Information about this inspection

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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