Setting

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Announced 13 June 2005 The Commission for Social Care Inspection aims to:

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NR1 2SQ

• Put the people who use social care first • Improve services and stamp out bad practice • Be an expert voice on social care • Practise what we preach in our own organisation

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Reader Information Document Purpose Inspection Report Author CSCI Audience General Public Further copies from 0870 240 7535 (telephone order line) Copyright This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Internet address www.csci.org.uk Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 3 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Fostering Services. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online

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Every Child Matters, outlined the government’s vision for children’s services and formed the basis of the Children Act 2004. It provides a framework for inspection so that children’s services should be judged on their contribution to the outcomes considered essential to wellbeing in childhood and later life. Those outcomes are: • Being healthy • Staying safe • Enjoying and achieving • Making a contribution; and • Achieving economic wellbeing.

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In response, the Commission for Social Care Inspection has re-ordered the national minimum standards for children’s services under the five outcomes, for reporting purposes. A further section has been created under ‘Management’ to cover those issues that will potentially impact on all the outcomes above.

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NR1 2SQ

Copies of Every Child Matters and The Children Act 2004 are available from The Stationery Office as above This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 4

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SERVICE INFORMATION

Name of service Norfolk County Council Fostering Services (Short Term Foster Care)

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SERVICE INFORMATION

Address Social Services, County Hall, Martineau Lane, Norwich, Norfolk, NR1 2SQ

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of places

n/a Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 5

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Brief Description of the Service:

Norfolk Social Services Fostering Service is contained within the Children and Families division of Norfolk Social Services. The Service is divided into 3 main areas, mainstream fostering, specialist fostering and short term breaks. The short term break scheme is managed within the children with disabilities service. Some parts of the work are shared between the short term break scheme and the main fostering (foster panels, personnel) and others are specific to the short term break scheme. This report focusses on the short term break scheme. Under this scheme children will stay with carers for agreed times, this may be infrequently such as one day a month or more frequently such as two days a week. The children live with their parents at all other times and parents retain parental responsability. The purpose of the scheme is to support families and provide additional experiences for children

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Brief Description of the Service:

with disabilities. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 6

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SUMMARY

This is an overview of what the inspector found during the inspection.

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SUMMARY

This inspection involved meetings with foster carers and workers singly and in groups, discussions with some parents, interviews with managers and key staff, case tracking of four sets of carers, reading of records, questionnaire surveys of carers, children (to complete with their parent’s help where appropriate) and placing social workers, and the observation of two fostering panels.

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What the service does well:

The short-term break service is a good one. It works well with parents and carers to ensure that children’s needs (including some complex health needs) are met. It provides positive experiences for children that help them to achieve their potential. Both parents and carers reported that children enjoy their stays with carers.

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What the service does well:

There is very good matching to make sure that children are placed with the best carers for them. Parents spoke well of this process. Training, adaptations and aids are provided to allow carers to look after the children well.

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What the service does well:

There is a thorough assessment and approval process for carers and they report that they are well supported by the service. Staff take pride in the work that they do.

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What has improved since the last inspection?

As this is the first inspection to concentrate on the short-term break service, it is not possible to assess everything that has improved, although there has been a lot of development to work towards meeting the National Minimum Standards.

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What has improved since the last inspection?

The service has recently undertaken a review of the quality of care that it provides.

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What they could do better:

Staff recruitment process and records require attention in order to meet the Fostering Service Regulations.

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What they could do better:

The work to develop procedures and practices in order to meet the National Minimum Standards and further safeguard children needs to carry on and be completed, for example in areas such as the supervision of carers, the use of written agreements to set out the details of the placement and the Children’s Guide to the service. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 8

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CONTENTS

Statutory Requirements Identified During the Inspection Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 9

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The intended outcomes these Standards are:

• The fostering service promotes the health and development of children.(NMS 12)

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The Commission considers Standard 12 the key standard to be

inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for standard(s) 12

The fostering service works in partnership with parents to promote the health and development of children.

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EVIDENCE:

Carers are given appropriate health information to allow them to care for the children, and when necessary they are provided with training or instruction in medical procedures such as gastrostomy feeding or rectal diazepam.

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EVIDENCE:

Carers are given written parental consent forms for medical treatment and they keep records of any medication they administer. New methods of recording the administration of medication are being introduced to further improve the system. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 10

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The intended outcomes these Standards are:

• Any persons carrying on or managing the service are suitable. (NMS 3) • The fostering service provides suitable foster carers.(NMS 6) • The service matches children to carers appropriately.(NMS 8) • The fostering service protects each child or young person from abuse and neglect.(NMS 9) • The people who work in or for the fostering service are suitable to work with children and young people.(NMS 15) • Fostering panels are organised efficiently and effectively.(NMS 30)

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The Commission considers Standards 3, 6, 8, 9, and 15 the key

standards to be inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for standard(s) 3, 6, 9, 15, 30

Overall the fostering service works to keep children and young people who are placed with it safe; there is some very good practice. However there are some significant gaps, such as recruitment checks, that need to be addressed.

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EVIDENCE:

Carer’s homes are suitable for the children who are placed with them. Carers reported that any necessary adaptations or aids are provided by the short- term break service. A health and safety checklist has been introduced for family placement social workers (FPSWs) to undertake regularly as part of carer reviews. Some FPSWs reported that if there have not been any issues arising during the year, they will complete the form with the carer, but not necessarily check the accommodation themselves. National Minimum Standard 6 requires that foster homes are inspected annually and regulation 29 of the Fostering Services Regulations 2002 requires that reviews of carers includes assessments of the continued suitability of the household. The short- term break service manager must ensure that carer’s homes are inspected annually.

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EVIDENCE:

Carers and parents reported matching as being thorough and of a very good standard. One set of parents interviewed, reported that they had to wait for Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 11 around 18 months for a suitable match. This was due to the level of need of their son, and they feel that the wait was worthwhile to have got so good a match. Introductions are at the child’s pace. Good examples of thorough introductions were noted, as well as flexibility when introductions had gone well and the child was ready for an overnight stay before initially planned. The short-term break service is to be commended for their work in matching and introducing children to carers.

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EVIDENCE:

The carer’s preparation course covers child protection and safe care. It is recommended that consideration be given to ways of providing refresher training in these subjects. Safe care guidelines (including safe care agreements) are being introduced for all new placements and will eventually be in place for all carers and placements.

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EVIDENCE:

A selection of staff files was examined as part of the inspection. It was noted that the requirements of schedule 1 of The Fostering Services Regulations 2002 were not being consistently met. The short-term break service manager must ensure that recruitment checks as detailed in schedule 1 of The Fostering Services Regulations 2002 are met in all cases of staff recruitment. Responses to CRB checks should be kept until they can be seen by CSCI.

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EVIDENCE:

One of the four carers case tracked continued to care for a young adult who had been placed with her as a child; this is a private arrangement. This young adult’s stays often take place at the same time as a child placed by the short- term break service. The child’s parent and the carer commented on how much the child likes her stays co-inciding with the young adult. This is clearly a positive experience for the child. However, the short-term break service manager must decide what checks are carried out for regular adult visitors to the carer’s household at the time of children’s stays, at the least these should include a declaration of convictions.

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EVIDENCE:

Norfolk’s fostering service (including the short-term break scheme) uses five fostering panels. The addition of dedicated panel administrators has made a very positive difference to the functioning of the panels. Inductions and training are provided for panel members, and quality assurance measures are in place. It was noted evidence of panel members’ CRB checks are not kept and for some panel members there is uncertainty about the checks having been done. The fostering service manager must ensure that all foster panel members have CRB checks and that evidence of these checks are kept until CSCI have had the opportunity to see them as part of the inspection process.

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EVIDENCE:

Recruitment and assessment of carers is undertaken by FPSWs.

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EVIDENCE:

Specific Foster Placement Agreements, as defined in regulation 34 of The Fostering Services Regulations 2002, are not used. The Looked After Children paperwork does not meet the requirements of regulation 34, and children who are placed for less than 24 hours, but including an overnight stay, do not Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 12 qualify as looked after. In these cases Looked After Children paperwork is not completed, but a written agreement is.

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EVIDENCE:

Not all of the identified elements of the Foster Placement Agreement are relevant for short-term break placements.

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EVIDENCE:

The fostering service manager must ensure that until the Looked After Children paperwork is replaced, the additional information required by regulation 34 of The Fostering Services Regulations 2002 and standard 8 of the National Minimum Standards, which is relevant for short-term break placements, is recorded separately. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 13

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The intended outcomes these Standards are:

• The fostering service values diversity.(NMS 7) • The fostering service promotes educational achievement.(NMS 13) • When foster care is provided as a short-term break for a child, the arrangements recognise that the parents remain the main carers for the child.(NMS 31)

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The Commission considers Standards 7, 13, and 31 the key standards

to be inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for standard(s) 7,13 and 31

Children placed through the short-term break scheme are encouraged to achieve. This is done by the short-term break service working in partnership with parents and recognising that the parents remain the main carers.

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EVIDENCE:

This service is specifically for children who have some form of disability. Through the use of appropriate equipment, good planning and positive attitudes, the children are helped to achieve their potential and to lead as full a life as possible. Responses to placing officer’s questionnaires commented on the positive experiences that children got through their stays with carers. Parents spoken with also commented positively of the opportunities that their children received to experience independence and socialisation away from home.

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EVIDENCE:

The short-term break scheme does not have a range of carers from different cultural, ethnic and religious backgrounds, but neither are there many requests for such. Parents of those children from different backgrounds seem willing to accept the very time limited care from essentially white British carers. However, the service would seek to recruit carers specifically for any child where this was felt necessary and is open to the opportunity to recruit carers from any background.

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EVIDENCE:

Parents remain responsible for their children’s education, and due to the nature and timing of the short-term break care, the service has little involvement with the education of children placed through it. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 14 There is clarity within the short-term break service that parents remain the main carers for children. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 15

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The intended outcomes these Standards are:

• The fostering service promotes contact arrangements for the child or young person. (NMS 10) • The fostering service promotes consultation.(NMS 11)

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The Commission considers Standards 10 and 11 the key standards to

be inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for standard(s) 10 and 11

Children who use the service are encouraged to make a positive contribution in ways that are meaningful to them.

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EVIDENCE:

As the children are placed with the carers for short periods of time and return to their parents care, contact is not an issue. When carers have cared for children for longer periods they have come under the same procedures as for mainstream foster carers and contact has been addressed.

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EVIDENCE:

The service is looking at consultation in ways that is meaningful to those who use it. Carers and parents spoken with stated that they felt the service would listen to their views.

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EVIDENCE:

Children’s views are sought by carers, parents and social workers.

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EVIDENCE:

The recently completed review of quality of care included consultation with children, parents and placing social workers. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 16

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The intended outcomes these Standards are:

• The fostering service prepares young people for adulthood.(NMS 14) • The fostering service pays carers an allowance and agreed expenses as specified.(NMS 29)

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The Commission considers Standards 29 the key standard to be

inspected at least once during a 12 month period.

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JUDGEMENT – we looked at outcomes for standard(s) 29

The financial processes work effectively.

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EVIDENCE:

Carers reported that payments are made in a timely manner. There was a little confusion among some carers over the system for payments, which limits the number of hours that can be paid for in any 24 hour (day) period to 8 hours even if the child is at the carer’s for longer. This system is historical and there is little knowledge of its origins, but is well documented in the carer’s handbook and does cover the cost of looking after the child. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 17

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The intended outcomes these Standards are:

• There is a clear statement of the aims and objectives of the fostering service and of what facilities and services they provide.(NMS 1) • The fostering service is managed by those with the appropriate skills and experience. (NMS 2) • The fostering service is monitored and controlled as specified. (NMS 4) • The fostering service is managed effectively and efficiently.(NMS 5) • Staff are organised and managed effectively.(NMS 16) • The fostering service has an adequate number of sufficiently experienced and qualified staff.(NMS 17) • The fostering service is a fair and competent employer.(NMS 18) • There is a good quality training programme. (NMS 19) • All staff are properly accountable and supported.(NMS 20) • The fostering service has a clear strategy for working with and supporting carers.(NMS 21) • Foster cares are provided with supervision and support.(NMS 22) • Foster carers are appropriately trained.(NMS 23)

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The intended outcomes these Standards are:

• Case records for children are comprehensive.(NMS 24) • The administrative records are maintained as required.(NMS 25) • The premises used as offices by the fostering service are suitable for the purpose.(NMS 26) • The fostering service is financially viable. (NMS 27) • The fostering service has robust financial processes. (NMS 28) • Local Authority fostering services recognise the contribution made by family and friends as carers.(NMS 32)

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The Commission considers Standards 17, 21, and 24 the key standards

to be inspected at least once during a 12 month period.

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22, 23, 24, 25 and 26

There is sound management of the short-term break service and carers are well supported. Some areas such as supervision of carers require additional work to fully meet the required outcomes.

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EVIDENCE:

Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 18 There is a good Statement of Purpose. The service is in the process of designing a range of children’s guides that will meet the needs of the children who use the service. It is recognised that producing guides that can be understood by children using the service is vital, and that this is likely to take a little time. While such a thorough approach is to be commended, the short- term break service manager must ensure that the children’s guides are produced by the time set out in this report.

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EVIDENCE:

Staff report that workloads tend to be manageable when fully staffed, but that the new processes necessary to meet the National Minimum Standards and Fostering Services Regulations 2002 are currently adding to their workload and causing some pressure. There are 2 social work assistant posts within the service, which are beginning to be used to support FPSWs and remove some of their tasks.

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EVIDENCE:

Some carers reported that they have had lengthy periods without a named FPSW due to sickness, but that they could get hold of someone if they needed to.

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EVIDENCE:

It is recommended that managers monitor workloads, especially when there are vacancies or sickness, in order to assess the ongoing adequacy of staffing.

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EVIDENCE:

All FPSWs are qualified and well experienced in short-term break care.

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EVIDENCE:

Staff are organised into three areas within a county team. Each area meets as a “team” and staff reported that they appreciate the opportunity to meet additionally as a county team. Some staff reported that they had annual appraisals, others that they usually did, but they are currently just overdue and one member of staff who has changed jobs within the service is substantially overdue for an appraisal. The short-term break service manager must ensure that all staff receive regular appraisals.

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EVIDENCE:

There is a comprehensive and easily useable handbook for carers. Carers all reported that they got good support from the service and had contact numbers for out of office hours if they needed them, but any problems out of office hours are usually discussed directly with the children’s parents.

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EVIDENCE:

National Minimum Standard 22 states that all carers should be supervised by a named, appropriately qualified social worker, and that supervising workers should meet regularly with carers. The meetings should have a clear purpose and provide the opportunity to supervise the carer’s work. Carer’s files should contain records of supervisory meetings.

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EVIDENCE:

At present there is a mixed picture of how far this standard is met. Some carer’s files contained records of supervisory meetings and others did not. The concept of supervision of carers is a new one for the short-term break service, but FPSWs have always had regular contact with carers. The frequency of this Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 19 contact has been dependent upon the needs of the carers and how often they provide care for children.

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EVIDENCE:

It is recognised by CSCI that the situation for short-term breaks is different to that from mainstream (full-time) foster care. In order to meet the outcomes for this standard, it is recommended that FPSWs in discussion with their managers, agree a frequency of supervision for each carer that they supervise, that this frequency is recorded and that the FPSW meets with the carer as agreed to supervise their work. These meetings could be recorded in the carer’s file either in their contact sheets/detailed records or as separate notes. Managers should monitor the frequency and content of supervision. Similarly FPSWs and their managers should agree whether there is a need to visit the home unannounced and how often this should happen.

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EVIDENCE:

Foster carer training is organised by the FPSWs. Carers reported that they have been able to get training to help them care appropriately for the children placed with them, but some stated that they would like more training (no particular subject was identified). Of the 4 carers that were case tracked, one had not had moving and handling training. This is recognised by the service as essential training, and is a particular issue for this carer as she looks after a child who requires lifting. With this exception this standard would have been met. The short-term break service manager must ensure that all carers receive the training as necessary to enable them to care for the children who are placed with them.

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EVIDENCE:

Appropriate records are kept by the service.

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EVIDENCE:

For the most part the premises used by the short-term break service are appropriate. However, the office in the west of the county is shared with staff that do not work for the service, or for Norfolk’s Children’s Services. Consequently there can be issues of confidentiality when making telephone calls or discussing cases. The short-term break service manager must ensure that the offices used are suitable for the purpose. Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 20

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SCORING OF OUTCOMES

This page summarises the assessment of the extent to which the National Minimum Standards for Fostering Services have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection.

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SCORING OF OUTCOMES

4 Standard Exceeded (Commendable) 3 Standard Met (No Shortfalls) 2 Standard Almost Met (Minor Shortfalls) 1 Standard Not Met (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable

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SCORING OF OUTCOMES

BEING HEALTHY ACHIEVING ECONOMIC Standard No Score WELLBEING 12 3 Standard No Score 14 x STAYING SAFE 29 3 Standard No Score 3 3 MANAGEMENT 6 2 Standard No Score 8 4 1 2 9 3 2 x 15 1 4 x 30 1 5 x 16 x ENJOYING AND ACHIEVING 17 3 Standard No Score 18 x 7 3 19 x 13 x 20 2 31 3 21 3 22 2 MAKING A POSITIVE 23 2 CONTRIBUTION 24 3 Standard No Score 25 3 10 x 26 2 11 3 27 x 28 x Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 21 Are there any outstanding requirements from the last inspection? yes

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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, Fostering Services Regulations 2002 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales.

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STATUTORY REQUIREMENTS

No. Standard Regulation Requirement Timescale for action 1. 6 29 The short-term break service manager must ensure that carer’s homes are inspected annually. With immediate effect for all future annual reviews 2. 15 20 The short-term break service manager must ensure that recruitment checks as detailed in schedule 1 of The Fostering Services Regulations 2002 are met in all cases of staff recruitment. Responses to CRB checks should be kept until they can be seen by CSCI. With immediate effect upon receipt of this report

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STATUTORY REQUIREMENTS

3. 15 27 The short-term break service manager must decide what checks are carried out for regular adult visitors to the carer’s household at the time of children’s stays, at the least these should include a declaration of convictions. 31 August

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STATUTORY REQUIREMENTS

4. 15 and 30 20 The fostering service manager must ensure that all foster panel members have CRB checks and that evidence of these checks are kept until CSCI have had the opportunity to see them as part of the inspection process. With immediate effect upon receipt of this report

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STATUTORY REQUIREMENTS

5. 8 34 The fostering service manager 30 Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 22 must ensure that until the Looked After Children paperwork is replaced, the additional information required by regulation 34 of The Fostering Services Regulations 2002 and standard 8 of the National Minimum Standards, which is relevant for short-term break placements, is recorded separately. September

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STATUTORY REQUIREMENTS

6. 1 3 The short-term break service manager must ensure that the children’s guides are produced by the time set out in this report. 31 Deceber

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STATUTORY REQUIREMENTS

7. 18 21 The short-term break service manager must ensure that all staff receive regular appraisals. September

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STATUTORY REQUIREMENTS

8. 23 17 The short-term break service manager must ensure that all carers receive the training as necessary to enable them to care for the children who are placed with them. September

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STATUTORY REQUIREMENTS

9. 26 23 The short-term break service manager must ensure that the offices used are suitable for the purpose. september

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RECOMMENDATIONS

These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out.

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RECOMMENDATIONS

No. Refer to Standard Good Practice Recommendations

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RECOMMENDATIONS

1. 23 It is recommended that consideration be given to ways of providing refresher training in child protection and safe care. 2. 18 It is recommended that managers monitor workloads, especially when there are vacancies or sickness, in order to assess the ongoing adequacy of staffing. 3. 22 It is recommended that FPSWs in discussion with their managers, agree a frequency of supervision for each carer that they supervise, that this frequency is recorded and that the FPSW meets with the carer as agreed to supervise Norfolk County Council Fostering Services (Short Break Foster Care) I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 23 their work. Managers should monitor the frequency and content of supervision. Similarly FPSWs and their managers should agree whether there is a need to visit the home unannounced and how often this should happen. Norfolk County Council Fostering Services (Short Break Foster Care)

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RECOMMENDATIONS

I55s61001NCCFosteringv220582130605 Stage 4.doc Version 1.20 Page 24

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Commission for Social Care Inspection

rd Floor, Cavell House St Crispins Road Norwich NR3 1YF

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Commission for Social Care Inspection

National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI

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