Inspection report for children's home Unique reference number Inspection date Inspector Type of Inspection SC002264 12 October 2009 Caroline Brailsford Key Date of last inspection 23 February 2009
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3 of 8 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. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment. The inspection judgements and what they mean Outstanding: Good: Satisfactory: Inadequate: this aspect of the provision is of exceptionally high quality this aspect of the provision is strong this aspect of the provision is sound this aspect of the provision is not good enough
4 of 8 Service information Brief description of the service The home provides care for children aged between seven and 16-years-old and is registered for a maximum of six children. The home is situated close to local amenities including schools, parks and public transport. It provides medium to long-term accommodation for children with emotional or behavioural difficulties. The home offers large attractive grounds for children to play and is fully accessible to all the children who are resident. All bedrooms are single and these are located on the first floor. There is an adjoining flat which includes the manager's office, staff sleeping quarters and a meeting and education room. The house is located near to the city and close to a wide range of local amenities and bus routes. Summary This key inspection was unannounced and all key national minimum standards were inspected. Each of the outcome areas have been given a judgement rating. Positive contribution, enjoying and achieving,, organisation, staying safe and being healthy are all judged as good. Economic wellbeing is judged as satisfactory. The 3 recommendations set at the last inspection are all met. The home provides a good service to the young people who live there. Strengths included the staff who are very familiar with the needs of the young people. They are sufficient in number to be able to spend quality time with them to get to know them well. Behaviour management is particularly good and ensures that young people can make good progress. Also young people experience a wide range of leisure activities and are encouraged in their hobbies and interests. The staffing ratio allows for this to be progressed in a way which is individually suited to young people. As a result of this inspection, 3 actions have been made relating to keys not fitting into the locks properly, the kitchen floor which looks unsightly and health plans which do not contain a high level of detail about existing medical conditions and how they should be met. Also there are 2 recommendations set which are regarding electrical testing which is overdue, and risk assessments for when young people go missing. Although these are detailed, they do not reflect the level of detail of the actual procedure in practice. The overall quality rating is good. This is an overview of what the inspector found during the inspection. Improvements since the last inspection The 3 recommendations from the last inspection have all been achieved. Procedures for the administration and recording of medicines are improved and staff have received training to ensure their competence in this. They are clear about the instructions of all the medicines in the home.
5 of 8 The details of Ofsted are now available in the complaints procedure and the staffing policy now contains the details of how staffing is arranged by day and by night. Helping children to be healthy The provision is good. Young people enjoy the food in the home and participate in decisions about the menus. This ensures that likes, dislikes and individual needs are properly catered for. The planned menus reflect a healthy, balanced and nutritious diet. Clarity of information on foods that young people should avoid is not always clear so has the possibility to be overlooked by the staff. General health has a high profile in the home and the young people are taught to make the link between exercise and good health. All young people are actively encouraged by the staff, in their chosen exercise on a regular basis to help to keep them fit and active. Young people receive good support from staff with regard to their health and emotional wellbeing. Health plans contain health information and staff are familiar with this information ensuring that young people's health needs are met. However, health plans do not always reflect the full extent of health issues. This has the potential for important information to be missed. Staff are good at identifying emotional needs of the young people and their emotional wellbeing has a high profile. This ensures that all aspects of health are fully considered. There are robust procedures for the storage, handling and recording of medicines. This ensures that young people receive their required medication on time and according to the prescription. Staff have received training in the administration of medicines and are clear about each medicine and how it should be administered. All staff members have completed a first aid course, the result being that there is always a first aider in the home ensuring the safety and welfare of the young people. Protecting children from harm or neglect and helping them stay safe The provision is good. Young people enjoy privacy in the home and the staff are good at teaching and encouraging young people to develop their dignity. Young people use and are very familiar with the complaints procedure. They are confident that if they pass a concern on to a staff member, that something will get done. They have been involved in developing the welcome pack and therefore know where the important telephone numbers are and who else they can pass concerns on to. This helps to protect individuals and ensures that all young people have a voice. Staff are clear about the risks that young people present. Risks are clearly identified, well managed and robust processes help to ensure the safety of young people. Work takes place on educating young people about how to keep themselves safe and this support is very individual. Should young people go missing, there is a very clear procedure identified in each young person's risk assessment. Staff are very familiar with the steps that they should take to ensure that young people are as safe as possible. However the risk assessments do not always reflect this high level of detail. The staff are trained in safeguarding and are clear about what they should do if there is a safeguarding issue. They are very clear about what actions they need to take for individuals,
6 of 8 and have regular contacts with placing authorities. Important information is passed on promptly. This ensures that an overall picture can be established about risk and vulnerability and therefore keeps the young people as safe as they can be. Young people enjoy good relationships with staff and spend quality time with them. The staff see them in a positive light and try to understand the reasons for behaviours so that support can be given prior to an incident escalating. Staff have completed training and are competent in diffusing situations to try to avoid the use of physical intervention. Where this is needed it is the last resort and well recorded. They are patient and calm in their approach and try to find the route of the problem so that young people can progress in their overall behaviour. The building is safe and checks are regularly carried out on fire equipment, gas and electrical, portable appliances. However the three yearly test for electricity in the home is overdue by 4 months. Staff and young people know what to do should there be a fire as they have practiced the fire drill. The fire risk assessment identifies risks and is clear regarding actions that staff should take, therefore minimising risk as far as possible. This helps to keep staff, visitors and young people safe. The keys that staff hold, fit into the locks poorly and some locks take a second or third attempt to open. This has the potential to put young people at risk should a lock need to be overridden in an emergency. The recruitment system in the home is robust and maintains good levels of safety for young people. This includes Criminal Records Bureau checks at enhanced level, proof of identity and references prior to employment. The registered manager is fully involved in the recruitment process so that the right candidate is selected according to the home's statement of purpose and the needs of young people. Helping children achieve well and enjoy what they do The provision is good. The young people's care plans are comprehensive and have a high level of detail. The staff know the required information well so that the care plan is delivered according to individual needs. Care plans are regularly scrutinised ensuring their effectiveness. Key working sessions are regular and focus on agreed issues from the care plan and review as well as day to day issues for young people. Staff are creative and flexible when supporting young people ensuring that they have an approach that works for each individual. Education has a high profile and young people are encouraged at every opportunity in their attendance and progress. Young people enjoy their placements which are suited to their needs and abilities. Full information about statements of special educational needs is available in the home and liaison with schools is regular to ensure that staff are up to date in their knowledge. Young people enjoy their leisure activities both in the home and out in the community. There is an emphasis on personal choice and young people are encouraged in their abilities, interests and hobbies. Activities include fishing, bike riding, parks and also holidays. A wide range of activities are offered and young people attend events and clubs in the local area. Staff put great effort in keeping young people busy and there is a link made between boredom and more difficult behaviour. Helping children make a positive contribution The provision is good.
7 of 8 Each young person has a care plan which works well in practice. The staff clearly know the information and young people very well, understand what their needs are, and therefore know how they should be met. The plans are well monitored and are shared with the placing authority. This ensures that the work is transparent and that the views of the placing authority can be established and taken into consideration. There are regular statutory reviews for young people and all information regarding the review meeting is kept together. The staff are well aware of the key information from these meetings and decisions are incorporated into the delivery of the care. Young people are supported to attend the meetings if appropriate so that they are involved in decisions which are made. Young people contribute to decisions about their own life and about the running of the home. There are regular questionnaires, key working sessions, young people's meetings and these all help the young people to express their views and wishes. There is a strong emphasis on consultation and there are regular examples of where it is clear that action has been taken by the staff to ensure a proper response. Achieving economic wellbeing The provision is satisfactory. Young people live in a pleasant and comfortable home which is very suited to them individually and as a group. They each have their own rooms which are well personalised. The building is generally well maintained but the kitchen looks unsightly as the flooring has come away underneath and around the cooker. This looks very difficult to keep clean and potentially could cause a risk to the health of the staff and young people. There is a process for pathway planning in the home, should young people reach the age where this is appropriate. Young people can develop their independence and practice the skills that they will need in adulthood. This provides them with confidence that will support their future economic wellbeing. Organisation The organisation is good. The registered manager knows the needs of the young people well and has a broad knowledge of operational issues in the home. There are 2 senior staff that also deputise in his absence which works effectively. Efficient systems are in place to scrutinise the quality of care being delivered, and the management team are confident that quality assurance reflects young people's experience of the provision. Staff and young people are happy with the management of the home. However staff report a feeling of low moral. This is related to personnel issues, where staff feel that they are poorly supported by the organisation. They are very clear that this has not impacted on the care of the young people. However this has the potential to be an issue in the future with regard to retaining staff. The promotion of equality and diversity is good. Each young person is seen as an individual and is treated as such. The statement of purpose reflects the work that takes place with young people and has been reviewed since the last inspection. Young people have been involved in
8 of 8 developing the young people's guide to the home and therefore the document is user-friendly and suited to their needs. Young people receive good quality care due to the skills and competence of the staff group. Staff are trained to a suitable level and know the needs of individuals well and how they should be met. The systems for the exchange of information are particularly good and therefore staff can keep abreast of the most current information in complex situations. This ensures that the needs of the young people can be met properly. There are enough staff on duty and a rota shows who has been on duty and when. The rota provides continuity and there is a mix of skills, gender and age in the team so that the young people can experience diversity. Each child has a permanent and private file, which is comprehensive and shows a clear a record of each young person s progress. The files contain all the required information and there is a high level of detail. However the information is presented in a way in which is a little cumbersome. What must be done to secure future improvement? Statutory requirements This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, The Childrens Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales. Standard Action Due date 12 26 23 ensure that young people have a health plan covering allergies, 20 November 2009 medical history and health interventions that may be required. This is in particular relation to the detail about existing conditions (Regulation 12.2) ensure that unnessessary risks to health and safety of young 20 November 2009 people are identified and so far as possible eliminated. This is in particular relation to the keys which fit in to the locks poorly (Regulation 32,c) ensure that the premises is maintained to a good standard. This is in particular relation to the kitchen floor. (Regulation 31,2,e) Recommendations 20 November 2009 To improve the quality and standards of care further the registered person should take account of the following recommendation(s): ensure that the written procedures for when a young person goes missing are clear (NMS 19.2) ensure that electrical installations are checked every three years. (NMS 26.4)