Children's Home run by The Together Trust in Stockport

SC025745 Unique reference number 30 June 2009 Inspection date Monica Hargreaves 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: SC025745

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Brief description of the service

This children's home is owned and managed by a charitable organisation. The service provides short break care for up to five young people of either sex aged from five to 17 years, who have autistic spectrum disorder and/or challenging behaviour. The main responsibility for meeting young people's needs remains with their parents or carers.

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Brief description of the service

The house is close to a small shopping centre and there are a range of local amenities within a short distance. There are five bedrooms which young people use when they stay at the home, a lounge, sensory room and computer room. There are sufficient bathroom and toilet facilities for all the young people who use the service. The house has been adapted to provide a safe environment for the young people who stay there. It has a large enclosed garden with suitable toys and equipment.

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Brief description of the service

The home currently provides a service to 24 young people at different times. Three young people were present at this inspection.

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Summary

This unannounced key inspection was arranged to assess how well the service is meeting the needs of young people in all outcome areas. All key standards were considered. The recommendations made at the last inspection were also reviewed.

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Summary

The home provides a very good standard of care. Young people's health needs are met very well and their education is promoted. They receive an excellent level of individual support. Staff have a very positive view of the young people who use the service and are keen to help them to enjoy their stay.

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Summary

Keeping young people safe is a high priority in the service and there are robust structures in place to make sure that young people are cared for safely and protected from abuse and bullying. The environment is kept safe and well maintained, so that young people who use the service, benefit from living in a setting that is homely and comfortable.

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Summary

There is a thorough assessment and sound care planning process, which means that the needs of young people are clearly understood before they stay at the home. However, the lack of up to date reviews for some young people means that there has been no recent assessment of whether or not the placement continues to meet their needs.

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Summary

The home is well managed and checks on the standards of care are regular and thorough. There is as yet no written development plan for the service. Staffing levels are very good, which ensures that young people are safe and well cared for and there is a consistent team of care workers, so that young people know the staff who look after them. Staff are competent and are properly trained for their work, but they are not yet sufficient qualified staff to meet the standards. The overall quality rating is good. This is an overview of what the inspector found during the inspection. 4 of 9 Inspection Report: SC025745

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Improvements since the last inspection

Two of the three recommendations that were made at the last inspection are fully met. There is evidence to confirm that all young people who stay at the service have been involved in a fire drill, so that staff can be sure they know how to evacuate young people safely from the building in an emergency. Records now contain the time of the fire drill, so that the home can demonstrate that a drill has taken place at night, as required by the standards.

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Improvements since the last inspection

One recommendation from the last visit is not fully met. Although there is a plan in place to make sure that all staff become qualified, there are not yet sufficient qualified staff to meet the standards. This recommendation is carried forward.

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Helping children to be healthy

The provision is outstanding. Due to the nature of the service, parents retain the main responsibility for the overall health needs of their children, but there are excellent systems in place to make sure that every young person's health needs are met very well when they are looked after at the home.

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Helping children to be healthy

Detailed support plans, which are based on thorough assessments, contain full information on the young person's health needs and relevant medical history, including for example, information on allergies, medication and care routines. These plans show how staff will work with the young person, so that their good health is promoted in the home and so that care is consistent within the team. Staff speak to parents regularly, so that they know the information they have about young people is up to date and accurate. They also have established links with agencies outside the home who provide additional support to young people, if a need is identified. The organisation provides training to staff on specific health conditions, such as epilepsy or autism, so that staff are properly equipped to care for young people with diverse and complex needs. Staff develop a very good understanding of every young person's specific needs so that they

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Helping children to be healthy

The home's procedures for the safe storage and administration of medication are robust and protect young people very well. For example, all staff are trained in safe practice in relation to administering medicines. Medication is stored safely and records are clear, kept up to date and are regularly monitored by the manager and senior staff, to ensure they are accurate. Medication is brought in with the individual young person and is only administered in line with the pharmacist's written instructions, to protect the young person. Training in first aid is kept up to date, so that staff know how to care for young people safely in an emergency.

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Helping children to be healthy

Due to their specific needs, some young people have a diet that is self limiting. However, staff make sure that all young people are encouraged to eat healthy foods when they stay at the home. Menus are planned ahead, to reflect the individual preferences and cultural and religious needs of all the young people staying at the home at any one time. Staff help young people to choose foods they like, using the Picture Exchange System (PECS) symbols. There is always an alternative meal available for young people and staff are trained in food hygiene so that they understand how to prepare and store food safely.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. 5 of 9 Inspection Report: SC025745 Excellent care practices and highly effective systems, ensure that young people are protected from abuse and bullying and from going missing from the home. For example, staffing levels are very good, so that young people are properly supervised both inside and out of the home which keeps them safe and there is a clear protocol to protect young people if they go missing. There have been no recent incidents of unauthorised absence. As part of their induction process, staff are trained to understand the signs and symptoms of abuse. The training is regularly renewed, so that their understanding of issues is kept up to date. There is a sound procedure on safeguarding children and young people, which staff understand and follow if there is a concern, which means that young people are protected. Individual assessments on young people enable staff to identify possible concerns about bullying and to put in place plans to minimise

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Protecting children from harm or neglect and helping them stay safe

the risk of this occurring. The booking system is used to plan short breaks, so that young people do not generally stay at the home with other young people they do not get on with. This also reduces the risk of difficult situations arising between individual young people.

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Protecting children from harm or neglect and helping them stay safe

Staff demonstrate a strong commitment to ensuring that young people are treated fairly in the home and also to ensuring that their rights to privacy and confidentiality are properly protected. For example, they practice in a way that protects the personal dignity of young people when they deliver personal care and ensure that information about young people is locked away to protect confidentiality.

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Protecting children from harm or neglect and helping them stay safe

The service has a clear complaints process and staff are keen to help young people to make their views and dissatisfactions known. Information is given to parents about how to complain and the manager and staff encourage parents to let them know if they are unhappy with any aspect of their child's care. There has been only one complaint since the last inspection, which was responded to promptly and in line with the organisation's complaints procedure.

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Protecting children from harm or neglect and helping them stay safe

Some of the young people who stay at the home can display behaviour that is challenging. Staff are trained to respond positively to this. The training covers the use of physical restraints. Staff develop specific behaviour support plans for individual young people, to enable them to employ agreed strategies to divert young people and minimise the risk of situations escalating. Evidence from this inspection indicates that physical intervention is minimal and only ever used as a last resort and that young people's welfare is promoted by the way they are cared for. Staff show a very positive regard for the young people they look after and are keen to praise and reward positive behaviour. Sanctions are not used as a way to manage behaviour, as staff do not believe these are effective or appropriate to the needs and understanding of young people.

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Protecting children from harm or neglect and helping them stay safe

Health and safety matters are managed very well, so that young people benefit from being cared for in an environment that is kept safe. A senior staff member takes a lead role in this area of work to ensure that there is good oversight. Equipment is regularly checked and all risk assessments, for example on the environment and on activities, are kept up to date. Young people are involved in fire evacuation drills, so that they can learn what to do and so that staff can practice evacuating them from the home in an emergency. The house and garden are kept appropriately secure, to prevent unauthorised access whilst allowing young people freedom of movement around the home and in the garden.

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Protecting children from harm or neglect and helping them stay safe

Staff recruitment and selection procedures are robust. Staff are thoroughly vetted, before they start work, to assess their suitability to work with vulnerable children and young people. Young 6 of 9 Inspection Report: SC025745 people and their parents are invited to be part of the staff selection process, to encourage their involvement in the work of the home.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people are given an excellent level of individual support when they use the service. Individual care and support plans are thorough. They are developed from the thorough assessments that take place before the young person stays at the home and are kept up to date through discussion with parents and professionals involved with the young person. All of the young people who use the service have complex needs and many young people do not use speech. Staff have an excellent understanding of how each young person makes their needs known, which enables them to give young people the care and support they need.

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Helping children achieve well and enjoy what they do

The home has very effective structures to ensure that the education of young people is promoted during their stay. Staff work closely with schools, attend all annual reviews and make sure that there is regular communication with teaching staff. They visit schools and use the young person's home/school diary to record information on the young person's stay. The service is well equipped to support learning outside of formal teaching. For example, there is a computer with internet access, which young people use with staff support and supervision and numerous books, games and toys to promote and support learning. Staff work with young people and their families to identify things that young people are particularly interested in, so that they can promote these activities in the home. They celebrate and reward every young person's achievements, for example producing certificates that can form part of the young person's 'memory file' that

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Helping children achieve well and enjoy what they do

they take with them when they leave the service.

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Helping children make a positive contribution

The provision is good. Admissions to the service are well planned and the manager makes sure that the time taken for each admission is appropriate to the needs of the individual young person and their family, so that they are properly supported. Staff work closely with placing authorities and families during the time their child uses the service, to help them to identify a provision that is suitable for their child when they move on from the home.

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Helping children make a positive contribution

Young people's care during short breaks is also carefully planned. The assessment process is thorough so that staff make sure they have the information they need to care for the young person properly. Support plans are holistic and take account of the young person's needs in every aspect of their care, including those arising from their religion, culture and background. Not all of the young people who are placed by local authorities are considered by them to be formally looked after, and for these young people, local authorities do not provide formal reviews. The care of young people is monitored in the home and where authorities themselves do not arrange formal reviews, the manager organises a review in the home, which social workers are invited to attend. At the time of this inspection, there was evidence that not all young people had an up to date review, to confirm that their placement in the service is meeting their

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Helping children make a positive contribution

Staff consult regularly with parents, by phone, in meetings and through written questionnaires, to keep them fully informed about the care their child is receiving and to seek their views on how the service could be improved. Staff also make sure that there is regular consultation with 7 of 9 Inspection Report: SC025745 young people during their stay at the service. Each young person is cared for on a one to one basis, which supports good communication. Staff have devised a system of 'social stories', using PECS symbols and simple language, which they use with young people, in individual sessions and in house meetings, to talk to them about issues in the home and their care and to help them to make their views known.

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Helping children make a positive contribution

The promotion of family contact is not an issue in the service, as young people live with their families. However, when children are at the home, they can keep in touch with their parents by phone.

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Achieving economic wellbeing

The provision is good. One of the stated objectives of this service is to help young people to prepare for life and the way that staff work with young people helps them to do this. Staff are keen that young people should enjoy their stay at the home. They encourage them to develop their interests and skills and promote their access to resources outside the home as well as their participation in activities in the community. Some young people learn to make drinks and snacks, whilst other young people are helped to increase their self care skills or to develop their communication skills, all of which is aimed at enhancing their quality of life.

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Achieving economic wellbeing

The service provides young people with a pleasant, homely environment when they stay. The house is well maintained, internally and externally and has sufficient communal and private space, to meet the needs of the young people who use the service. Bedrooms are large and airy and pleasantly decorated. Staff encourage young people to bring small personal items in with them and try to ensure that young people are able to use the bedroom they prefer every time they stay. Bathroom and toilet facilities give young people appropriate privacy and the house and garden are secure, to prevent unauthorised access and keep young people safe.

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Organisation

The organisation is good. Written information about the service is made available to social workers, parents and young people, so that they know what the service offers young people and how they will be cared for. The parents guide is clearly written and contains information for young people that is presented in a format of symbols and simple language, that is suitable for their needs. The statement of purpose is kept up to date and generally gives a good indication of how young people are looked after. However, there is a gap in the information contained in this document, as it does not clearly state the ages of young people who are looked after and therefore does not fully meet the standards.

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Organisation

Young people benefit from being cared for by an appropriate number of staff, so that they are properly looked after and are able to take part in activities in the home and off site. There are arrangements for cover when the manager is away from the home and there is an established team of staff, which means that young people know the staff who look after them. Staff are trained to understand and meet their needs. At this inspection, there was evidence that staff are working to gain a relevant qualification, but that there are not yet sufficient qualified staff to meet the standards. 8 of 9 Inspection Report: SC025745 Staff feel they are properly supported in their work. Overall, supervision takes place at regular intervals and in line with the standards, although there are some gaps in supervision sessions for some members of the team. The induction process for new staff is thorough, which helps them to understand and settle into their role quickly and therefore provide a good standard

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Organisation

Management systems ensure that the work of the home is closely monitored. These include regular checks completed by the manager as well as those done by an independent person. Detailed reports of this monitoring work are available and show that action is taken to address any issue that is identified. Evidence from this inspection, confirms that the home is working in line with its statement of purpose, but there is no written development plan for the home.

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Organisation

Young people's files are well ordered and kept secure. Information from other records is cross referenced in their files, so that young people and their parents have access to a detailed record of their history in the placement.

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Organisation

The promotion of equality and diversity is outstanding. The organisation has a specific policy on promoting equality and valuing diversity to guide staff in their work and provides them with training. There is frequent reference to these issues throughout the documents in the home and staff discuss them in team meetings, so that the principles are embedded in practice. Staff are committed to ensuring that all young people are treated fairly and equally and to making sure that their rights are promoted. The home provides a service for every young person that is tailored to meet their individual and specific assessed needs.

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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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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • make sure that every young person has an up to date review of their care in the service (NMS 3.3) • include in the Statement of Purpose details of the age range of children and young people to be cared for (NMS 1.2) • ensure that a minimum ratio of 80% of all care staff hold an appropriate qualification (NMS 29.5) • produce a written development plan for the service (NMS 33.5). 9 of 9 Inspection Report: SC025745

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