Children's Home run by North East Lincolnshire Council in North East Lincolnshire

SC033127 Unique reference number 25 August 2009 Inspection date Sarah Urding Inspector Key Type of 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 9 Inspection Report: SC033127

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Brief description of the service

This home is part of the children's disability service offering care for children aged between five and 17 years with learning disabilities and physical disabilities.

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Brief description of the service

The property is purpose built on one level and provides accommodation for seven children receiving respite services. Longer-term care can be offered to three young people within an attached bungalow, which is self-contained.

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Brief description of the service

The home is well equipped, offering very good facilities for young people. Externally there are three separate and well-equipped play areas.

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Brief description of the service

The home is situated near a town centre and public transport is accessible.

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Summary

This was an unannounced full inspection. All key standards were inspected along with an assessment of progress made since the last inspection. The home is providing satisfactory outcomes for children with some good and outstanding features. Children's health needs are well met because staff are proactive and understand how to meet a range of complex medical conditions. Positive working relationships with health professionals and parents ensure that children develop well. There are excellent systems in place for promoting safe working practice and children's dignity is exceptionally well promoted. Children enjoy their time in the home and can make a positive contribution because staff know the children they care for, listen well and are empowering. Staff are committed, well supported and trained well to meet the needs of children they care for. However, staff do not have consistently good information about

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Summary

children's educational needs for short-term breaks, which means that opportunities to promote learning are missed. Consistency in the provision of care is compromised because some placement plans do not clearly reflect practice and reviews are not timely or fully implemented in a minority of cases. Young people with disabilities are not being given equality of opportunity in relation to transition planning which compromises their life chances. 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

The home has not made satisfactory improvement in relation to meeting the recommendations made at the last inspection. There are still inconsistencies regarding the promotion of education beyond the school day because staff do not fully understand their roles and they do not have the information to inform them about children's levels of attainment. This reduces learning opportunities. However, children and young people are now able to access the garden, which promotes freedom of movement.

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Helping children to be healthy

The provision is good. Children and young people eat healthy, well-balanced meals. Excellent attention is paid to dietary requirements in line with children's needs. Staff support children and young people well during mealtimes and assist in a sensitive low-key manner. Wherever possible children are 4 of 9 Inspection Report: SC033127 encouraged to feed themselves, which promotes their dignity and encourages independence. Staff and children understand the importance of exercise and diet in order to promote healthy lifestyles.

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Helping children to be healthy

Children and young people's good health is well promoted by staff who are trained to understand complex medical conditions and have well established relationships with health professionals and parents. Staff are proactive in monitoring children's needs and they take appropriate action when needs change. Staff work closely with specialist health care providers to ensure that children receive the services and equipment they need. Staff receive detailed information about children's health care needs and there are clear plans in place to ensure consistent and safe working by staff.

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Helping children to be healthy

Medication is well managed and administered appropriately. Of note is the understanding shown by staff of the types of medication children are prescribed and any potential side effects. Staff are vigilant about monitoring changes in medication and ensure that they administer medication as prescribed. Staff challenge appropriately and seek medical advice when there are any discrepancies with medication for children receiving short break services. This ensures their good health is maintained. Medication is securely stored and fully accounted for. Training for staff in the administration of rectal diazepam has been provided although some staff have not worked with children requiring this medication for some time and lack confidence in this area. This is pertinent should there be a need for staff to support in other areas of the home.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. Children and young people's welfare is of paramount importance in the home. Staff work in a sensitive manner when carrying out personal care tasks and the promotion of dignity is at the forefront of practice. Children and young people value the approach of staff and are particularly positive about the promotion of personal space. The manner in which staff manage risk with the need to promote privacy is commendable.

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Protecting children from harm or neglect and helping them stay safe

Children and young people are safeguarded because staff follow best practice guidelines in relation to child protection and complaints. Staff empower children to have a voice and work in partnership with parents to ensure that any arising concerns come to the fore. Staff listen and value children, which creates an open and inclusive environment. Staff are vigilant, report concerns appropriately and monitor well to ensure that children are protected from harm.

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Protecting children from harm or neglect and helping them stay safe

Staff are well trained in managing challenging or unsafe behaviours. They are knowledgeable about individual risk because detailed information is provided prior to placement and strategies are devised and fully implemented. This encourages a consistent approach. Staff are fair and measured in their approach and challenge inappropriate behaviours such as bullying promptly. Behaviour management is effectively and rigorously monitored by senior staff. The risk of children going missing is significantly reduced because of the very good levels of staff supervision.

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Protecting children from harm or neglect and helping them stay safe

The environment is safely managed and good attention is paid to health and safety. Some positive work has been undertaken with children and young people with regards fire safety.

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Protecting children from harm or neglect and helping them stay safe

The risk to children and young people of being exposed to potential abusers is reduced because staff are safely recruited and visitors to the home effectively monitored. 5 of 9 Inspection Report: SC033127

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Helping children achieve well and enjoy what they do

The provision is satisfactory. Children and young people are offered very good levels of individual support in line with a range of complex needs. Needs arising out of any disability are well met by staff. Of note is the manner in which staff are proactive in seeking external services for children and ensuring changing needs are met promptly. For example, the review of medication and equipment for children. Staff know the children they care for well because they spend one to one time with them and monitor their development. However, the promotion of needs arising out of culture and identity is less well developed and not clearly recorded. This does not encourage consistent working or ensure needs will be met.

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Helping children achieve well and enjoy what they do

Education and learning is inconsistently promoted. Whilst staff work closely with teaching staff to promote attendance and communicate changing needs, their understanding of children's levels of attainment in school is variable. There are clear education plans and statements of special educational need in place for looked after children and for some children receiving short breaks. However, staff are not confident about the needs of all children placed because information is lacking and they do not fully understand their roles in this regard. This is not conducive to promoting learning beyond the school day and opportunities to further children's development are being missed.

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Helping children make a positive contribution

The provision is satisfactory. The majority of placement plans in the home inform staff well of the individual needs of children and young people and how to meet them. Placement plans have been adapted to more appropriate formats and are completed in partnership with parents and their children. This promotes accuracy in planning and greater understanding of individual need. However, a small minority of plans have not been updated following reviews or recommendations implemented. Lack of detail in some placement plans also compromises service delivery and staff consistency. Placement planning is unclear particularly in relation to young people's identity and issues arising out of culture. Reviews are timely in the majority of cases, which ensures that children's changing needs are promptly identified and met. However, staff are not consistently alerting placing authorities when reviews of care are overdue and as a result, arising needs may be

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Helping children make a positive contribution

There are clear processes in relation to admissions. The admission criteria are clear, well managed and children are appropriately placed. This reduces the risk of a placement breaking down and there is confidence that the needs of the children placed can be met.

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Helping children make a positive contribution

Staff work in partnership with parents and the very positive relationships maximise support for children. Parents value the service and say that communication is 'excellent'. Staff are fully aware of the differences in their roles between providing short break services and permanent care. Staff advocate well on behalf of parents in order to secure positive outcomes for their children.

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Helping children make a positive contribution

Staff communicate effectively with children and young people using their preferred method of communication. This enables children to contribute to life in the home. There are a variety of forums available to encourage children's participation including one to one work, children's 6 of 9 Inspection Report: SC033127 rights meetings and through providing accessible information and advice. This practice promotes self-confidence and shows children that they are valued.

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Achieving economic wellbeing

The provision is satisfactory. Young people are not being afforded equality of opportunity with regards transition planning. Staff are not advocating strongly enough on their behalf to ensure that plans are in place to outline how future needs are to be met. The transition between children's and adult services is not adequately planned which compromises preparation time for young people and the input required to ensure that life chances are optimised. However, care staff are focused on ensuring that young people are equipped with life skills appropriate to their abilities and understanding. Staff are particularly good at empowering children and young people from the outset to take responsibility for self-care skills and mobility where possible. Staff have developed strong partnerships with parents and education professionals, which strengthens support networks for young people.

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Achieving economic wellbeing

The home is purpose built and is furnished and decorated to a high standard. There are excellent facilities for children to enjoy and their bedrooms are warm, comfortable and personalised. Maintenance issues are dealt with promptly and areas for further development highlighted.

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Organisation

The organisation is good. There is a clear statement of purpose in place outlining the services available to children. This informs people well of the services they can expect to receive. However, the statement relating to the bungalow has not been updated to reflect the changed use of one of the rooms, which is now unavailable for children to use. A clear children's guide is in place, which is in a format that children can understand and some positive work has been undertaken to ensure that children understand their rights.

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Organisation

The promotion of equality and diversity is satisfactory. Although there are some very positive outcomes for children and young people in relation to needs arising out of health, safety and contribution. Needs arising out of any disability children have are individually well met in relation to diet, medication, the promotion of privacy and dignity and communication. Advocacy, empowerment and risk management are strengths of the home and this promotes equality of opportunity well. However, there are inconsistencies in relation to managing transitions for young people, the promotion of learning beyond the school day and in the promotion of their identity, which compromise young people's life chances.

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Organisation

Children and young people's individual and complex needs are met by staff who are appropriate in numbers and skills. Staff are very well supported, know the children they care for well and are child centred in approach. Staff value an effective induction and are well informed because they are updated regularly with required and specialist training. The service responds well to the needs of children and has the ability to provide flexible care packages as children's needs change. This has recently involved the movement of some staff between homes to ensure continuity of care. Whilst this is good practice, it has impacted upon the overall training matrix for the home with regards refresher training for administration of rectal diazepam and National Vocational Qualification (NVQ) training. 7 of 9 Inspection Report: SC033127 There is some excellent practice in relation to monitoring the quality of care in the home. A

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Organisation

clear plan of development for the home is in place and understood by staff who make effective contributions. Robust systems are in place to ensure that monitoring is child centred and children's rights workers visit regularly to speak on behalf of children and make comment on the quality of care provided. This is in addition to the monthly visits carried out on behalf of the responsible person and weekly meetings held by the senior management team to monitor all aspects of performance. There is clear accountability in the home and actions recommended from these processes are carried out promptly. However, the action taken in response to the visits by children's rights workers is not well documented and some of the shortfalls highlighted during the inspection have not been identified by the management team.

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Organisation

Records of young people's lives in the home are well looked after and outcome focused but there are some inconsistencies relating to the detail within placement plans.

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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

10 September 2009 ensure that the placement plan is consistent with any plan for the care of the child prepared by his placing authority (Regulation 12(4)(a)) 10 September 2009 keep under review and where appropriate revise the statement of purpose, in particular provide a clear account of the current facilities available in the bungalow and notify the regulatory body of any such revision within 28 days (Regulation 5(a)(b))

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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 that each child's file contains a record of their educational achievements, needs and aspirations, to include children receiving respite services and ensure that staff are familiar with the educational histories of children(NMS 14.2). • ensure the placement plan sets out clearly the assessed needs of the child particularly in relation to cultural, religious, language and racial needs and how they will be met (NMS 2.1) • contact placing authorities to request reviews when due for any child, if the placing authority has not arranged the review (NMS 3.3) • ensure there is a comprehensive plan for young people preparing to leave care which specifies the support and assistance they will need to receive to enable a successful transition into adulthood and ensure this is consistent with and contributes to any transition plan for

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Recommendations

children with disabilities and special educational needs (NMS 6.1) 8 of 9 Inspection Report: SC033127 • ensure staff receive training opportunities that equip them with the skills required to meet the needs of children, in particular provide refresher training in the administration of rectal diazepam (NMS 31.1) • keep a record of the action taken in response to the visits conducted by the children's rights officer (good practice recommendation relating to NMS 32.3) 9 of 9 Inspection Report: SC033127

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