NATIONAL ASSEMBLY FOR WALES
CARE STANDARDS INSPECTORATE FOR WALES
Care Standards Act 2000
INSPECTION REPORT CHILDREN'S RESIDENTIAL CARE
Blaenau Children`s Centre
DATE OF PUBLICATION - 27 September 2006
You may reproduce this report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the written consent of the National Assembly for Wales.
CARE STANDARDS INSPECTORATE FOR WALES
BWest Wales Regional Office Government Buildings Picton Terrace Carmarthen SA31 3BT
01267 223402 01267 242924
Inspection report for the year: 1 April 2006 - 31 March 2007
Name of children's home:
Blaenau Children`s Centre
Contact telephone number:
Mr Anthony Maynard is currently being nominated as the new Registered Provider.
Number of places:
Date of first registration:
18 December 2003
Dates of this inspection episode from: 12 August 2006 to: 8 September 2006
Dates of other relevant contact since last report:
Date of previous report publication:
6 January 2006
Not applicable to this inspection
Other regions contributing to this report:
Not applicable to this inspection
This report has been compiled following an inspection of the home undertaken by the Care Standards Inspectorate for Wales (CSIW) under the provisions of the Care Standards Act 2000 and associated Regulations.
The primary focus of the report is to comment on the quality of life and care experienced by service users.
The report contains information on the process of inspection and records its outcomes. It is divided into nine parts reflecting the broad areas of the National Minimum Standards. An overall conclusion of the home's compliance with the Children's Homes (Wales) Regulations is recorded.
CSIW's inspectors are authorised to enter and inspect children's homes at any time. During each inspection episode or period there are visit/s to the service, some unannounced, in addition to a range of other activities such as discussion groups, self-assessment and the use of questionnaires. CSIW tries to find the best way of capturing service users' and their relatives'/representatives' views and experiences of using the service. At any other time throughout the year visits may also be made to the service to investigate complaints and /or in response to changes in the home.
Inspection enables CSIW to satisfy itself that continued registration is justified. It ensures compliance with:
. · Care Standards Act 2000 and associated Regulations, whilst taking into account the National Minimum Standards
· The home's own statement of purpose
Over a 12 month period inspectors will:
. · Spend time with service users and seek to engage them in conversation, in private as necessary
. · Inspect the accommodation used by service users
. · Talk to the manager and each group of staff
. · Satisfy themselves that all records are being properly maintained
Readers must be aware that a report is intended to reflect the findings of the inspector during a specific inspection period. Readers should not conclude that the circumstances of the service will be the same at all times; sometimes services improve and sometimes they deteriorate. The National Minimum Standards are very technical and detailed in nature and CSIW does not closely examine all aspects of these standards on each visit.
If an aspect of the service falls short of that required to meet the regulations, CSIW will make requirements on the service to make improvements. The report clearly indicates any such requirements made by CSIW. This will include any made since the last inspection report which have now been met, any that remain outstanding and any new requirements arising from this recent inspection. Where requirements are made, the provider may develop an action plan to show how they plan to make the necessary changes and you may wish to discuss this with them.
The reader should note that requirements made in the previous report which are not listed as outstanding have been appropriately complied with. The report will also comment on aspects of service that are felt to be positive.
If you have concerns about anything arising from the inspector's findings, you may wish to discuss these with CSIW or with the registered person.
The Care Standards Inspectorate for Wales is required to make reports on registered facilities available to the public. Most reports are public documents and will be available on the CSIW web site: www.csiw.wales.gov.uk
In order to protect the interests of children resident in them, reports on children's homes will not be available on the intranet. Persons requiring a copy of a children's home inspection report should contact the regional office for the area within which the home is located.
SUMMARY OF FINDINGS
This inspection of Blaenau Children's Centre was conducted under the reform of
regulations. Therefore, the children and their families, together with those who have a
professional input into the home have been consulted and their views have been
expressed throughout the body of this inspection report.
The following methodology was also undertaken during the inspection episode.
Pre inspection visit - 25 July 2006.
Announced inspection - 7 August 2006.
Semi announced inspection - 5 September 2006.
Interviews with 3 families, which included parents and children.
Questionnaires to all other families who use the service.
Interviews with 6 residential care staff.
Questionnaires to all other residential care staff.
Discussions with key workers/social workers.
Self assessment documentation.
The inspector also had access to all policies, procedures, files and documentation held
within the home together with the opportunity to observe practice and interaction amongst
staff and the young people who use the service.
All the families spoken with or who received questionnaires were extremely positive about
the centre, the staff who worked there and the service which they received. Their
comments together with the findings of the inspectors has resulted in a very positive
inspection episode for the centre which needs to be congratulated for the quality of service
which it provides.
Families further stated that the respite service, which they received, was an essential part
of theirs and their child/young persons lives. It allowed for the young people to experience
some independence whilst families were able to pursue activities that would not be
possible If this service was not provided.
Following the last inspection undertaken in July 2005 certain requirements and
recommendations were made which have been addressed in a recent action plan (July
2006). All of those requirements and recommendations have now been either fully met or
met in part and will be referred to in this inspection report.
Only 2 new requirements have been made during this inspection which are stipulated in
sections 5 and 6 of this report (staffing and conduct and management of the service).
Also, 2 good practice recommendations have been made under Section 8 (physical
GOOD PRACTICE COMMENTS
SECTION ONE CHOICE OF HOME
Blaenau is a residential facility which together with its sister centre Llys Caradog based in Llanelli provides residential respite care for children with disabilities who reside in the Carmarthenshire area. Both centres are owned by Carmarthenshire County Council and managed by the Education and Children's Services Directorate.
Blaenau Children's Respite Centre is located just over 2 miles from the town of Ammanford and provides up to three respite care placements to children and young people with complex disabilities who are between the ages of 5-18 years.
The statement of purpose for the home was last updated in June 2005 and provides comprehensive information regarding the centres aims and objectives together with information on admission criteria and processes and how children will be cared for during their stay. This document meets the requirements of Regulation 4, Schedule 1 of the Children's Homes (Wales) Regulations 2002.
However, this statement of purpose needs to be further updated particularly as there is likely to be changes with regards the registered person (see Section 6 - Conduct and Management of the Service).
It was also noted that some of the policies and procedures had not been updated for a number of years and should now be re-looked at with a view to updating where necessary.
The children's guide "Daniel goes to stay" was designed to help to introduce children to the concept of what a respite centre actually does. The guide is informative and child friendly and written in both english and welsh. It also provides useful information to the parents with regards to how their child will be cared for whilst at the centre.
A requirement from last years inspection was for the booklets which accompanied this guide and explains the complaints process should be developed so that they can be understood by children who use other methods of communication. I was assured by the centre manager that this has now been completed and the new booklets are currently in the process of being printed.
All the families contacted during the course of the inspection stated that they had seen the statement of purpose and the children's guide and that they had been given plenty of information on the centre and how it functioned.
Referrals to the centre were made via. a Service Allocation Meeting which was attended by a range of professionals from the local authority, the managers of both centres and personnel from Barnardo's family links project. The criteria for admission is based on the child/young person's needs as assessed by the National Framework for Assessment.
Following assessment, those children and young people who it was felt would benefit from this service would receive a very flexible and sensitive introduction to the centre.
Initially contact would be made by the centre manager with the child's key worker and family and as much information as possible would be gathered about the child/young person. Families would then be encouraged to visit the centre and discuss all aspects of care provision etc. prior to making a decision as to whether they felt this service would meet their needs. Any complex health needs would be overseen by a qualified paediatric nurse who would if necessary undertake a home visit prior to any admission.
Initially children and young people were offered a number of introductory tea visits which could span over several months if that is what is deemed to be in the child's best interest. No child/young person would be allowed an overnight stay until it was assessed that they were ready for this to happen. Attempts were also made to try and arrange visits for children to spend time at the centre with other children who may be known to them via. school etc.
All families consulted with regarding this process were very complimentary with regards to the way in which introductions were managed. Some families stated that they had been very anxious about letting their children/young people stay at the centre and for some this process had taken up to a year. Families stated that this was not a reflection on the centre but due to their own protectiveness of their children and young people. Families also commented on the good communication from staff during the introductory period and that staff had always made time for them.
The leaving process for young people at the age of 18 years was not so clear. Generally young people were not entitled to a service from the centre following the month of their 18th birthday although in certain circumstances this could be extended for a further 3 months.
The manager informed that they were now more involved in the transitional arrangements for young people. However, there was a general feeling particularly from parents that more information, support and services were required from the local authority. Parents stated that they were unhappy with the current 18year plus provision. However, the inspector did evidence during the inspection one young person who was close to reaching their 18th birthday having received introductions to a new provision and being supported by the centre in the transitional process.
Requirements made since the last inspection report which have been met:
Requirements which remain outstanding:
(previous outstanding requirements)
New requirements from this inspection:
Good practice recommendations:
NMS or other source
SECTION TWO - PLANNING INDIVIDUAL NEEDS AND PREFERENCES
Blaenau currently provides respite services for up to 27 children and young people with a small number of children currently undertaking introductory tea visits. The centre has complied with the guidelines as set by the Children Act 1989 in that no child should receive more than 120 days respite care per year.
The majority of respite care is provided overnight and at weekends although there is an opportunity for up to a week's respite during the school holidays if that is the identified need.
The admission process is via. a referral from the key worker of the Family Support Team. All referrals are then discussed at the fortnightly Service Allocation Meeting and if accepted a planned admission takes place.
The manager insists that all documentation relating to the Looked After Children system be completed prior to any child having overnight stays. This documentation includes a care plan which is completed in conjunction with the child/young person, family, centre staff and all other professionals associated with the child. In addition to this care plan individual plans are undertaken by centre staff which sets out the personal programmes for each child. These plans also contain information on all assessments including moving and handling, medication and behaviour management.
All of these plans are subject to review. The Looked After Children care plan is reviewed within 3 months of an overnight stay having taken place and then annually unless there was a specific need to review more frequently. An independent reviewing officer has been employed by the local authority for 10 hours per week to undertake these reviews. The reviewing officer was pro active in visiting the children and their families prior to review and children were encouraged to attend and participate in their meetings where appropriate.
During the course of the inspection several of the children's main files were sampled and all documents relating to the children's care plans were seen to be completed and up to date. These files were kept secure in the office at all times which was kept locked when not in use.
The individual plans for each child which sets out information on children such as individual preferences with regards to likes and dislikes, medication etc. together with details of telephone numbers were kept readily to hand for each child currently in respite. Any changes to those plans were noted in the files but brought to each care workers' attention via. the daily record book which is read by each member of staff coming on duty.
All care workers consulted with during the course of the inspection stated that they had access to all information on the children's care plans and they knew when any of these plans had been updated and/or changed. Eighteen parents were either directly consulted with or completed questionnaires during the course of the inspection, apart from 1 parent all others stated that they knew the care plan for their child. Parents also stated that they were confident that the care plans for their children were being followed.
Requirements made since the last inspection report which have been met: Action required
Requirements which remain outstanding: Action required
(previous outstanding requirements)
New requirements from this inspection: Action required
Good practice recommendations: NMS or other source
SECTION FOUR- QUALITY OF CARE AND TREATMENT
Blaenau is able to provide respite care for up to 3 children and young people at any one time. Due to the fact that the accommodation is all on one floor a number of the children and young people using this service are wheel chair users. Staffing is provided on a 1 to 1 basis which provides adequate supervision of children in promoting their care and welfare.
This inspection episode was conducted during the summer holidays therefore the inspector had opportunity to observe the interactions between the staff and children. It was evident that good relationships had developed as there was always a good atmosphere within the centre with plenty of communication between children and staff.
Discussions with families evidenced that children really looked forward to going to the centre and enjoyed their time there. Some children stated that they wished they were allowed to go to Blaenau more often.
Parents stated that they felt that the centre offered children a certain amount of independence in that they were encouraged to make new friends which increased their confidence and social interactions. This also had a positive impact on parents themselves who felt that seeing their children grow in confidence had also allowed them to make certain changes. An example of this was a parent who before her child started going to the centre would always have her child sleep in the same room as herself. Since going to the centre and sleeping in his own room this has now given her the confidence to allow her child to sleep in his own bedroom at home.
Each child had their own individual needs and attempts were made to encourage children and young people to participate in independent living skills. Some children particularly enjoyed cooking and were allowed under supervision to assist in baking a cake or making scrambled eggs.
A behaviour management policy is operated within the home and staff receive training in this during their induction period. This training ensures that staff develop a consistent approach and that they are confident in managing certain children's behaviour.
The previous inspection noted that staff had not received training in managing behaviour for a period of 12 months and a requirement had been made for all staff to receive updated training. This requirement has now been met as a 2-day training package was provided in February 2006 and covered areas such as use of restraint, measures of discipline and positive means of control. This training however continues to need to be provided on a yearly basis particularly as a number of relief and day care staff have recently started their employment at the centre.
Children and young people are encouraged to eat a varied and healthy diet that incorporated those children with special dietary or religious requirements. Meal planning and preparation is generally undertaken by the night staff who plan for the forthcoming week taking into account children's likes and dislikes. The centre caters for children who may have gluten free diets and care is given to ensure that children are not made to feel different or excluded if they are on special diets. One child informed the inspector that he did not like sausages therefore when they were on the menu he would be offered an
SECTION FIVE - STAFFING
The staffing complement for Blaenau consists of the centre manager, 1 child care liaison officer, 1 senior residential child care officer and 4 residential child care officers who were not full time but worked a variety of contracted hours. In addition there were a number of day and night care assistant posts who were also contracted to work a variety of hours together with a pool of relief staff who covered as and when required.
All staff were subject to the local authorities recruitment and selection process which included the need for enhanced criminal records bureau checks to be undertaken together with two references. A good practice recommendation from the previous inspection was for copies of all the information required by Schedule 2 to be held on staff files at the centre. This recommendation has now been met as it was evidenced during this inspection that references were now being securely and confidentially held at the centre.
All staff employed at the centre whether as a permanent member of staff or relief were expected to undertake a period of induction which took up to 12 weeks to complete. This induction included core training either provided in house or via. the local authority's training department. Numerous policies, procedures and guidance were available to all staff together with clear job descriptions and copies of the centre's statement of purpose. The Children's Homes (Wales) Regulations 2002 were held at the home together with a copy of the National Minimum Standards.
The majority of the staff interviewed at the home stated that they had received a thorough induction to their role including a period of being allowed to shadow more experienced staff. Most staff were satisfied with the support and initial training they had undertaken which they felt had given them confidence to undertake the role of caring for children and young people with disabilities.
However, it was noted from interview with one member of staff that they felt their induction was somewhat rushed due to staff shortages and the demands of the school holidays. This had resulted in this member of staff not having had sufficient opportunity to familiarise themselves the with policies, procedures and regulations etc.
Staff consulted with indicated that supervision was taking place monthly by the senior staff within the centre, supervision notes were written up and signed by both the supervisor and supervised. All staff stated that they felt that they were listened to and that they had opportunities to contribute their views in supervision and staff meetings.
It was noted however during the course of the inspection that new staff recently appointed had not been receiving supervision on a fortnightly basis as in line with the National Minimum Standard 21.2.
A requirement from the last inspection was for the manager to introduce an annual appraisal system. There was evidence to suggest that this requirement had now been almost met as the majority of the staff consulted with stated that they had either received an appraisal or had one arranged in the near future.
Information on staff meetings were observed during the inspection and although minutes were available, it was noted that meetings were not always occurring on a monthly basis.
It was acknowledged during the inspection through discussion with the manager and staff that there had been staffing difficulties due to maternity and sickness. There were occasions when the manager struggled to cover shifts and, as staff were very mindful of the dependency that families had on the services of the centre every effort was made by staff to cover those shifts in order to prevent cancellation of a child's respite break.
It was the view of the inspector that the staff at the centre were highly committed individuals who undertook additional hours in order to ensure the continuation of service.
The inspector concluded that any non-compliance with regards to the supervision of staff or irregularity of staff meetings were due to the demands of the service and the difficulties caused by staff shortages and vacancies. The inspector was also aware that there was a differential in the payment and conditions of service between permanent and relief staff. This differential may have played a role with regards the recruitment of staff and impacted on the covering of additional shifts particularly at weekends.
A requirement from this inspection is for the registered person to ensure that there is at all times a sufficient number of suitably qualified, skilled and experienced persons working at the centre as in line with regulation 25 of The Children's Homes (Wales) Regulations 2002.
Supervision of the manager was undertaken monthly by the senior principal officer who had responsibility for the management of the centre. This supervision was undertaken jointly with the child care liaison officer for both Blaenau and Llys Caradog and managers of both centres. One to one supervision could be provided on request of any party. An appraisal of the manager had also been completed and again this was undertaken in conjunction with the manager of Llys Caradog. The inspector however, wishes to draw to the attention of the registered provider that in order to comply with standard 21.2 all staff should receive one-to-one supervision from a senior manager once a month.
A good practice recommendation from the previous inspection was for the manager to complete her NVQ 4 qualification in caring for children and young people by April 2006. However, due to inconsistencies with NVQ assessors and the demands of the service this has yet to be completed. The manager however, has set herself a target for completing this training by Autumn of 2006. The manager is also aware of the need to undertake her NVQ 4 in management, which complies with the requirements of the Care Council for Wales.
From information supplied in the self-assessment documents it was noted that staff had a range of experience and qualifications with 6 staff having undertaken their NVQ 3 qualification. Although it was noted that all but 1 staff member were registered to undertake their NVQ3 there were a small number of staff who had been undertaking
SECTION EIGHT - PHYSICAL ENVIRONMENT
Blaenau children's residential centre is a detached bungalow located in a quiet village approximately just over 2 miles from the town centre of Ammanford. The front of the property has recently benefited from having off road parking provided which allows for children to safely access transport.
Externally the property is in good decorative order and there is a secure area at the rear of the property, which is easily accessible to children, and young people who may be wheelchair users.
It is noted from the last inspection report that reference was made to the rear garden being `too boggy' and again this issue was raised with staff, families and professionals who attend the home. The treasurer of the parents group informed the inspector that several thousands of pounds was required to drain the garden area and although some monies had been raised via sponsored walks etc they were still not in a financial position to undertake this work.
The inspector felt that the centre would really benefit from this drainage work being undertaken in the garden. This would then allow for the garden to be further developed to provide a safe and interesting outside space for the children to access. Due to the fact that a lot of children who use this centre are wheelchair users it is not always possible to take the children out. This garden space is therefore important as it does give the children the option of playing outside particularly during the summer months.
A good practice recommendation is made in line with The National Minimum Standard
34.4 that gardens and/or hard play areas are well maintained and safe.
Internally the size and design of the property is more than adequate to accommodate the children and staff. The main living areas are spacious, adequately furnished and equipped. One of the key workers who had responsibility for a number of the children who received respite stated that parents were initially anxious about their children staying at the Blaenau. However, after visiting the centre they were reassured due to the homeliness and facilities provided together with the friendliness and positive attitudes of staff.
Each young person is allocated their own bedroom during their stay and where possible attempts are made for the children to stay in the same bedroom at each respite. The bedrooms are of a good size although it was the view of the inspector that some of the furniture and decoration was starting to look a little tired and would benefit from some updating. This view was also held by some of the staff who through interview and questionnaires stated that they felt some of the furniture was old and needed replacing and that generally the centre needed modernising. Several staff also referred to the children's beds as they felt there were benefits to the children to have cot sides that were perspex.
Although there were an adequate number of bathroom and toilet facilities the inspector's view was that the bathroom was not adequate with regards to health and safety issues. Some staff reported that the bathroom was seen as somewhat of a challenge in that the