Children's Home run by Fairfield Residential Limited in Trafford

SC387148 Unique reference number 19 May 2009 Inspection date Alicea Bennett Inspector Key Type of Inspection

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1 December 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 9 Inspection Report: SC387148

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Brief description of the service

This home is a newly purpose built premises to accommodate children with autism, learning disabilities, and physical disabilities. It is a substantial property built with these needs in the forefront of planning and construction. The home is a two-storey building; the first floor consists of a lounge for watching TV and relaxing with patio doors to the garden area, a dining room which also has patio doors, a kitchen area, a quiet area with touch screen computer and internet access, a sensory room, a class room and a staff office. There is a large garden and play area with outside play equipment to the gated grounds.

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Brief description of the service

There is a lift to the first floor upon which bedrooms, staff sleep-in accommodation and manager’s office are located. The home has sufficient washing, toileting and bathing facilities including a wet room and specifically designed rise and fall sink and bath. The house is situated in a residential area close to shops, public transport and community facilities. It also has dedicated transport for the children and young people.

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Summary

This was an unannounced full inspection. The purpose of the visit is to assess how the home is meeting the National Minimum Standards (NMS) and Children's Home Regulations. All of the key standards were assessed.

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Summary

Almost all of the key standards are met and many are exceeded. The home provides an excellent standard of care. There is a sustained track record of responding promptly to any issues that are raised during inspections and of reflecting on practice and seeking to improve the service that is offered.

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Summary

Children are cared for by an established, enthusiastic team of staff who are qualified and trained to understand and to meet their needs. Staff communicate well with each other and work closely with parents and a range of professionals to ensure continuity of care. They are committed to making each child's stay at the home an enjoyable experience and to helping them to develop through play and social interaction.

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Summary

There are three requirements in relation to updating the Statement of Purpose to reflect the registration age categories and current staffing list, ensuring that all checks in respect of staff recruitment are available for the purposes of inspection, and that Ofsted are alerted to all notifications of significant events. Three recommendations arising are in relation to monitoring of medication, in particular, those considered to be a controlled drug and ensuing that the staff qualifications in NVQ level 3 in Caring for Children and Young People meet the NMS. The home was in the process of an assessment to have to boiler outlet vent moved on the second day of the inspection, due to a potential hazard. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

This is the first key inspection of this service since the registration of the home. The staff, children using the service and the name of the home, all transferred into the new building in 4 of 9 Inspection Report: SC387148 December 2008. There were no requirements or recommendations arising from that last inspection.

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Helping children to be healthy

The provision is good. Children are provided with adequate quantities of suitably prepared food and drink with regard to their needs and wishes. They also have the opportunity to shop for and prepare their own snacks. The home maintains copies of menus that reflect the meals served; this demonstrates that children enjoy healthy, nutritious meals that meet their dietary needs. Individual needs and progress regarding eating different foods and textures is also recorded. Staff have worked hard to promote independence in relation to children and young people being enabled to feed themselves, help to make cakes, sandwiches, and drink from cups wherever possible. All but new staff have attended training in food hygiene.

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Helping children to be healthy

All of the children have comprehensive health plans, based upon thorough assessment of their individual needs. The documents from social workers and supporting information from parents have been used to collate the required information. Staff have access to good policies and procedural guidance in respect of health and health promotion. Staff and children have excellent access to a variety of health professionals to meet specific needs. All of these matters reflect that children live in a healthy environment, their health needs are identified, services are provided to meet them and their good health is promoted.

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Helping children to be healthy

The home has clear policy and procedural guidance for staff in relation to medication. This means that children's health needs are met and their welfare is safeguarded by the home’s policies and procedures for administering medicines and providing treatment. Storage is good with individual medication clearly labelled. The administration records are good, but do not give a clear indication of the quantity of controlled drugs that are on the premises at any one time. The manager is noted as regularly monitoring the records. All children have consent to medical treatment on their files. Staff have received training in the administration of medication and have undertaken specific training in relation to epilepsy and first aid. The home has first aid boxes that are regularly checked by a designated staff member.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. The home provides a privacy and dignity policy and procedure for staff; this includes personal care and assisted bathing guidelines. Children can have time alone in their rooms and their privacy is promoted and respected.

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Protecting children from harm or neglect and helping them stay safe

There is a clear complaints procedure incorporating a procedure for handling external complaints. Children and parents are given very clear information in the children's guide about how to complain and what they can complain about. Contact details for independent advocacy and Ofsted are also included. The home maintains a record of complaints, which is regularly monitored. Few complaints have been made. A dedicated record of complaints demonstrates that complaints are addressed seriously and immediately. The home has introduced a 24hr helpline, so that staff can offer support and where necessary, outreach services can be provided to parents needing support. 5 of 9 Inspection Report: SC387148 The welfare of children is promoted. They are protected from abuse and an appropriate response is made to any allegation or suspicion of abuse. The management and staff in the home have a very clear understanding of safeguarding and responding to such matters. Staff interviewed

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Protecting children from harm or neglect and helping them stay safe

are clear about their roles in reporting any incidents to the relevant authorities and their responsibilities in relation to the whistle blowing procedures.

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Protecting children from harm or neglect and helping them stay safe

Information is provided to children and staff about bullying and there are clear guidelines to follow in such circumstances. The behaviours displayed by children are clearly outlined in their plans; any behaviour that may arise as a result of a particular learning disability is taken into account.

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Protecting children from harm or neglect and helping them stay safe

There is a high level of staff supervision in this home and absence is not problematic. The registered person has a system in place to notify within 24 hours, the persons and appropriate authorities of the occurrence of significant events in accordance with Regulation 30. One incident has not been notified to Ofsted.

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Protecting children from harm or neglect and helping them stay safe

Any measures taken to respond to unacceptable behaviour are appropriate to the age, understanding and individual needs of each child. For example, taking into account that unacceptable or challenging behaviour may be the result of illness or certain disabilities. Each child has a behavioural assessment and because of this, a behaviour management plan is in place. All but new staff have received training in behaviour management, including the need to physically intervene if necessary. The records in the home demonstrate that use of sanctions is very low in number and no restraints have taken place. The records meet with regulation. Staff are observed to have a good understanding of individual children's behaviour.

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Protecting children from harm or neglect and helping them stay safe

Positive steps are taken to keep children, staff and visitors safe from risk from fire and other hazards. There are regular fire evacuations. The home has a variety of risk assessments in place in relation to both the home and individual children. There are certificates held on file in relation to Public Liability Insurance, the electrical installation and gas boiler maintenance. On the day of this inspection, the gas boiler outlet presented a potential hazard; this is in the process of being moved.

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Protecting children from harm or neglect and helping them stay safe

The majority of staff files inspected contain all of the information required and are orderly and accessible. There is a written record of the recruitment process, which is followed in respect of staff. There are some gaps in respect of complete employment histories and references in one case. These are reported to be held off site, and as a result, the home cannot demonstrate that the regulations have been met in every case.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people receive an excellent level of individual support when they stay at the home. Staff develop detailed, holistic, placement and support plans from the information they gain from parents and professionals from other agencies, so that the needs of young people are properly identified and can be met. The home has employed a speech and language therapist since the last inspection to develop communication with the children further.

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Helping children achieve well and enjoy what they do

Staff maintain very good communication with schools through the home school diary, so that they can support young people appropriately with their education. They visit schools, attend review meetings and regularly exchange information with teaching staff. The facilities available 6 of 9 Inspection Report: SC387148 within the home also help young people to learn through a touch screen computer and a tutor is available for children if their education placements are disrupted. As this is predominantly, a short breaks service, the main responsibility for the education of children and young people remains with their parents. However, there is a positive attitude within the home about the value of education.

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Helping children make a positive contribution

The provision is outstanding. The comprehensive assessment of young person’s needs ensures that staff are able to develop detailed, holistic, personal care plans for each young person. These placement plans are supported by additional risk assessment plans, such as behaviour support plans and contain developmental outcomes. Staff use these documents to make sure that the care that they give to young people is consistent within the service. Placement plans are kept under close review within the home and are reviewed at regular intervals by an independent person, to make sure that the young person's needs continue to be met by the service and to identify any areas of additional support they may need.

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Helping children make a positive contribution

Arrangements in relation to contact are good. Many of the children are placed on a shared care basis and families maintain close contact.

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Helping children make a positive contribution

There is a clear procedure for admissions to the home and about how the placements are managed. The needs of the child concerned, and the likely effects of their admission upon the existing group of residents, are taken into account. Issues surrounding compatibility are clearly addressed in practice. All admissions to the home are very well planned and managed to help young people to feel happy and settled about their stay. Young people are encouraged to bring favourite and cherished possessions with them when they stay at the home.

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Helping children make a positive contribution

Close attention is paid to helping young people to communicate their wishes and feelings. This has been a focus of development for the home and is working to good effect. Staff have developed the use of PECs (Picture Exchange Communication Systems) picture symbol system, which they use to help them to understand how young people feel about their stay at the home. This allows them to indicate their choice over such things as activities, meals or issues of personal care. Staff also communicate regularly with parents and main carers to keep them informed about the care of their child. Pictures of children out on activities and around the home are used in a computer presentation to accompany review reports to inform care planning and progress.

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Achieving economic wellbeing

The provision is outstanding. None of the children resident are subject to Pathway Plans due to their ages. The home has employed a tutor. The focus of the work undertaken with children is promoting their independence through everyday matters such as drinking from a cup or helping with laundry and self-reliance wherever possible.

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Achieving economic wellbeing

The home is newly built. The staff and children all moved into the home once works were complete. It is decorated and furnished to a very high standard, which creates a pleasant domestic environment. The size and the arrangement of the rooms meet the needs of the children and young people. The building of the new premises had the needs of the children at 7 of 9 Inspection Report: SC387148 the forefront of the planning. Provision for children and young people with disabilities is fully integrated into its design and layout. Suitable aids and adaptations are provided to enable children and young people to live as normal a life as possible. The interior and exterior of the home are maintained in a good state of structural and decorative repair. All of the bedrooms were highly personalised. The home offers excellent facilities.

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Organisation

The organisation is good. The Statement of Purpose is a detailed document; it gives very clear information about how children are cared for in the home and the staffing policy. However, it does not currently reflect the changes in the staff team or the age categories outlined on the registration certificate. The young person's guide is attractive and well presented in a form that is easily understood by children and young people and their families. It is developed for each individual child and includes pictures. It is a comprehensive document, which is well thought out.

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Organisation

The promotion of equality and diversity is good. Promotion of independence, choice and developing communication is excellent. There is a varied staff group in terms of age, gender and ethnicity. There is good evidence of developing cultural awareness through food and the celebration of festivals.

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Organisation

There is a competent staff team, with a good range of experience among its members. The skills within the team are well matched to the group of children and young people accommodated. There have been a number of staff who have left and recruitment of new staff to these posts is well underway. The number of staff who have attained their National Vocational Qualification (NVQ) level 3 in the Caring for Children and Young People currently stands at 25%. This figure has been affected by the changes in staffing. The vast majority of the remaining staff team are undertaking the award and two others are about to complete it. One of the senior workers has begun their RMA (Registered Managers Award).

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Organisation

Training opportunities are very good, providing staff with the knowledge and skills to understand and to meet the specific needs of the vulnerable children who use the service. Areas in which staff are trained include the management of epilepsy and gastric tube feeding, autism, communicating with children, cultural awareness and the management of challenging behaviour.

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Organisation

Gaps on the rota are covered by part-time staff working additional hours or by casual staff employed by the home. This means that young people are cared for by adults who are known to them and who understand their needs. There is sufficient staff on duty to care for the particular needs of the group of young people staying at the home at any one time.

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Organisation

There is good evidence that the manager and responsible individual closely monitor the overall running of the home in a purposeful way, which meets with regulation. They use monitoring to reflect on practice and consider ways of improving and developing their service to provide good and excellent outcomes for the children. This is evidenced in the development plan for the home. 8 of 9 Inspection Report: SC387148

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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

31 July 2009 ensure that the statement of purpose is updated to include an accurate staffing list and that the ages of children for which accommodation may be provided, is reflective of the certificate of registration (Regulation 4 and 5 and Schedule 1) 31 July 2009 ensure that without delay that all notifications of significant events are reported to Ofsted, and confirmed in writing (Regulation 30) 31 July 2009 ensure that all staff files hold information required in regulation and are available for the purposes of inspection (Regulation 26 and Schedule 2).

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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 there is an accurate written record of all medication (NMS 13.2) • regularly review the effectiveness of action identified as a result of risk assessments carried out, in this case the boiler outlet (NMS 26.3) • ensure that a minimum ratio of 80% of all care staff have completed their NVQ level 3 in the Caring for Children and Young People (NMS 29.5). 9 of 9 Inspection Report: SC387148

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