Children's Home run by St Helens Metropolitan Borough Council in St Helens

SC035971 Unique reference number 27 May 2009 Inspection date Sonya Robinson Inspector Key Type of Inspection

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24 November 2008 Date of last inspection .

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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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.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 10 Inspection Report: SC035971

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Brief description of the service

The home provides short term breaks for children and young people from the ages of seven years to 17 years, with physical, learning and sensory disabilities.

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Brief description of the service

Accommodation is provided over two floors. The ground floor includes a kitchen, two lounges, a light and sensory room, games room and dining room. Young people have their own rooms, which are located on the upper floor. The upper level of the home is accessible via a lift for those young people who use wheel chairs.

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Brief description of the service

The home is situated near a local town and is close to local leisure facilities, local amenities and transport links.

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Brief description of the service

On the day of this visit, several young people were present and met with the inspector.

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Summary

At this unannounced full inspection, all key standards were inspected. This is a satisfactory service overall.

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Summary

Young people benefit from positive relationships with staff. They are also afforded a range of facilities and opportunities to encourage and support a healthy lifestyle, to develop their life skills and to reach good outcomes from education. However, there are issues around lack of detail in the homes documentation within behaviour management plans, health care plans, risk assessments, placement plans, along with more frequently held staff supervisions and team meetings.

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Summary

Staff benefit from a good level of training and support, they work well with other professionals to meet the complex and holistic needs of young people in areas, such as emotional and physical wellbeing. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

There were four recommendations made at the previous inspection. The manager was asked to ensure that staff are appropriately trained in the safe handling and storage of medicines, this has now been completed. Also to ensure that there is an up to date placement plan for each child or young person accommodated at the home, demonstrating the individual support provided to each young person in terms of personal care, health care, social support and issues arising from disability. Each young person has a placement plan, however the level of detail is limited given the needs of the young people placed.

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Improvements since the last inspection

The manager was also asked to maintain an accurate and up to date record of measures of control used in accordance with the standards for children's homes and to ensure physical restrictions on normal movement within the home, for example, stair gates and high handles on doors are only used in relation to individual children to promote and safeguard their welfare. Physical restrictions must not impact on all children staying at the home. Both of these recommendations have not been actioned and are therefore highlighted again. 4 of 10 Inspection Report: SC035971

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Helping children to be healthy

The provision is satisfactory. Young people are provided with appropriate and nutritious meals and are encouraged and supported to participate in the planning of menus, food preparation and cooking by use of adapted facilities that are accessible and inclusive. Young people with particular dietary requirements, such as difficulties with eating associated with disability, are assisted by staff who are trained and competent in providing additional health and medical support. Many young people who access the service have very complex health needs, as well as other physical and learning disabilities.

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Helping children to be healthy

Young people have a health care plan, these allow for the health needs of young people to be assessed, monitored and appropriate action taken. Staff actively encourage young people to enjoy and participate in healthy activities and experiences. Young people have records that reflect their health care needs both inside the home and when out and about. This demonstrates a commitment to providing young people with positive healthy and stimulating experiences, whilst adopting an organised and safe approach. However, health care plans do not yet contain sufficient information about young people's health care needs.

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Helping children to be healthy

A medication procedure is in place to ensure the safe administration of medicines at the home. Staff are trained in meeting the specific needs of young people. This ensures that young people achieve assistance with any issues and staff achieve a consistent approach towards young people. However, the service is yet to fully complete and implement a review of their medication policy and procedure.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Staff demonstrate a caring approach to ensuring that young people feel valued and their privacy and dignity are maintained at all times. Staff have a clear and comprehensive understanding of young people's communication methods. This is used to ascertain individual opinions and feelings with regard to how they wish to be supported. Records are in place and explain how the home keeps young people safe in line with their assessed needs in areas such as safe moving and handling, absconding and medication. There is a fully accessible complaints procedure.

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Protecting children from harm or neglect and helping them stay safe

Staff support young people to address behaviours and enjoy positive relationships with others. This is achieved by employing systems and proactive practices which value and include young people. However, the documentation in place does not meet the legal requirements expected within a children's home and the behaviour management plans of young people do not have sufficient detail of their individual needs noted within them.

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Protecting children from harm or neglect and helping them stay safe

All staff working at the home are appropriately vetted and have attended a training programme which encompasses aspects of safeguarding young people with physical and learning disabilities, including delivering and maintaining safe practices around social and medical support needs.

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Protecting children from harm or neglect and helping them stay safe

The home keeps records about concerns regarding young people's safety, staff have also notified Ofsted of all incidents in line with Schedule 5 of the Children's Home Regulations. The home also has fire risk assessments and all necessary checks, such as gas and electric certificates in place. However, at the time of this inspection environmental risk assessments were in the process of being reviewed. 5 of 10 Inspection Report: SC035971

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Helping children achieve well and enjoy what they do

The provision is good. This service is not responsible for overseeing educational needs of young people as it is a short break service. However, they are positive and proactive in their approach to supporting the education of young people. Staff assist young people during their stays to attend school daily, they also make sure that young people have appropriate equipment and that they are fully prepared for the school day.

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Helping children achieve well and enjoy what they do

Staff support and actively encourage young people to take part in leisure activities. Young people can pursue particular interests, such as computer games or outdoor games if they wish. They have opportunities to develop confidence in their skills, enjoy their leisure time and try new things. Young people have access to a secure garden which includes various play equipment. Staff are skilled at encouraging young people to take part in activities and try new experiences. In holiday periods, the home has access to an appropriately adapted vehicle to enable young people's interests further into the local community.

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Helping children make a positive contribution

The provision is satisfactory. Young people have placement plans that identify their needs and outline the arrangements for meeting them. Young people’s placement plans are regularly reviewed to make sure that they are up-to-date and continue to meet their needs. Staff encourage young people’s families and friends to be involved with the service to make them feel welcome. This helps young people as information is shared. However, the level of detail within their placement plans does not reflect the specific individual needs of the young people placed.

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Helping children make a positive contribution

Young people enjoy warm relationships with staff, and staff are motivated and interested in young people. They enjoy spending time with young people and are proud of young people’s achievements. They have clear professional and personal boundaries with young people, consistent with good childcare. This demonstrates that the home is committed to providing an inclusive service that values individuals and enhances the positive outcomes for young people during their stays.

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Helping children make a positive contribution

Staff work well with young people to ascertain their opinions and feelings around the care and support they are afforded. However, the opinions and views of children on all matters affecting them, including day to day matters are not ascertained on a regular and frequent basis, for example, through key worker sessions, young peoples meetings and the use of advocates is not routinely maintained.

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Achieving economic wellbeing

The provision is satisfactory. Young people who stay at the home have a wide range of physical, emotional and learning needs and some also require specific medical and mobility support. The home is able to cater and meet young people's needs well, by providing appropriate equipment and by employing a staff team who are trained to support young people with additional needs. However, feedback with regards to young people being supported and assistance given to make the transition into adulthood, is that this could be improved upon. 6 of 10 Inspection Report: SC035971 The home uses a dual high handled system to all internal doors, safety gates and double lock to the exit doors. This prevents some young people from moving freely within the house. Although a risk assessment is in place for restricting movements within the home and individual risk assessments highlight young people with no awareness of danger who may abscond, they

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Achieving economic wellbeing

do not state how the liberty and rights of young people is promoted, in line with their individual and specific needs.

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Achieving economic wellbeing

All parts of the building to which young people have access are accessible, however some facilities, such as the bathroom and shower room are small and do not allow for young people who use wheel chairs to have all personal care tasks delivered in a way that promotes their privacy and dignity at all times.

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Achieving economic wellbeing

The accommodation provided is warm and welcoming. Young people benefit from a spacious environment that includes, two lounges, a play room, light and sensory room and dining room. However, due to some recent building work involving the replacement of many internal doors, there is exposed plaster work in parts around the home.

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Achieving economic wellbeing

The outdoor area also provides young people with more than ample space to relax and play.

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Organisation

The organisation is satisfactory. The promotion of equality and diversity is satisfactory. Young people's rights are respected and promoted. The service demonstrates that the individual care needs of young people are identified and that direct work with young people is undertaken. Their care needs are routinely monitored through systems in place. This ensures that the individual care needs of young people are met.

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Organisation

The home is well run and provides a safe and stable environment for young people. The manager shows effective leadership and a commitment to good child care.

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Organisation

Young people know what support they can expect from the home and how they will be looked after. The children's guide provides important information about the home in a way that is easily understood by young people. Also, the home has a clear written statement for parents and social workers of how the home operates and plans to meet young people’s needs.

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Organisation

Young people are looked after by competent and enthusiastic people who have suitable skills and experience to meet their needs. Staffing levels meet the needs of young people living in the home and provide young people with consistency and continuity of care.

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Organisation

Staff are well supported and guided in promoting and safeguarding young people's welfare on a daily basis, however, staff supervision is not consistently occurring on a monthly basis. Also, team meetings are not routinely taking place every month to discuss the care of young people and the running of the home.

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Organisation

The provider and manager regularly monitor the quality of care and report upon this. They take action to improve the service provided and promotes young people’s welfare. 7 of 10 Inspection Report: SC035971

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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.

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Due date Action Standard

30 June 2009 ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children's home, a written record is made in a volume kept for the purpose (Regulation (17) (4)).

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure each child or young person has an up to date health plan that fully identifies the physical and emotional health needs (NMS 12) • ensure that there is an up to date medication policy with written guidance, implemented in practice, for storing, disposing and administering medication (NMS 13.11) • ensure all unnecessary risks to the health or safety of the environment and to individuals are identified and where possible eliminated (NMS 26) • draw up for each child an up to date behaviour management plan which reflects the strategies employed to encourage and support positive behaviours (NMS 22) • ensure that there is an up to date placement plan for each young person accommodated at the home, that details sufficiently their assessed needs and describes how the home aims

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Recommendations

to meet them (NMS 2) • ensure the opinions and views of children on all matters affecting them, including day to day matters are ascertained on a regular and frequent basis, for example, through key worker sessions, young peoples meetings and advocates (NMS 8.4) • provide a plan for each young person preparing to leave care, which specifies the support and assistance they need to make the transition into adulthood (NMS 6) • ensure that the home is decorated and furnished to a standard which creates a pleasant domestic environment appropriate to the needs of the children accommodated (NMS 24) • ensure physical restrictions on normal movement within the home, for example stair gates and high handles on doors are only used in relation to individual children to promote and safeguard their welfare. Physical restrictions must not impact on all children staying at the home (NMS 23.5) • ensure all staff receive at least one and a half hours of one to one supervision from a senior

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Recommendations

member of staff each month (NMS 28.2) 8 of 10 Inspection Report: SC035971 • ensure that staff meetings occur at least monthly, and include discussion of both the home's work in caring for individual children and the management of the current child care group, together with review of the home's practices (NMS 28.10). 9 of 10 Inspection Report: SC035971

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