Children's Home run by Lancashire County Council in Lancashire

SC035428 Unique reference number 10 December 2009 Inspection date Stephen Trainor 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 10 Inspection Report: SC035428

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Brief description of the service

The accommodation is a short break home for children and young people with a disability. The home is operated by a local authority social services department. Support and care is provided for up to four young people, both genders, from five years old up to 17 years. The house is single storey, detached and adapted to support residents with a disability. Occupational health are consulted when changes to the building or specialist equipment is required.

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Brief description of the service

The home is situated fairly close to a large town centre. It has sufficient space and rooms, where the young people can pursue their leisure interests and hobbies. There is an enclosed garden at the rear of the home. A cinema and parks, as well as sports and athletics facilities are a short walk or journey away. The home has a specially adapted vehicle and is close to bus routes, that connect it with the local community and the national rail link. Shops and supermarkets are accessible within the surrounding community.

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Summary

This key inspection had a short lead in time. The report comments on every outcome heading covering all the key children's homes national minimum standards. Progress against recommendations made during the last inspection was evaluated.

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Summary

This is an outstanding service, providing a consistent response to meeting young people's specific needs. The diverse needs of 17 young people are well supported at this home. A clear strength of this service is shown within the personalised care planning arrangements. A wide range of equality and diversity matters are addressed and a high quality service is provided. Staff practice values individual difference.

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Summary

This home has a competent team of staff. Staff have established professional as well as supportive relationships with parents. Excellent communication and consultation ensures specific needs are addressed in a timely manner. Partnership arrangements with families, social workers and many different professionals and agencies are well established.

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Summary

There are many experienced staff members. Support and training ensures staff continue to develop skills and expertise. Staff remain highly motivated. Quality assurance systems demonstrate that the management team are reflecting on practice to continually develop the service in line with new initiatives. Young people are being looked after safely and have the opportunity to develop skills through the positive experiences they gain. A carefully coordinated response is taken to meet health needs.

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Summary

This report highlights some advisory recommendations. These mainly relate to plans for service development. A proposed residential redesign for children's and young people's disability services is an ongoing matter under consideration. The transitional arrangements, the move between children's services and adult services, could be improved. The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection. 4 of 10 Inspection Report: SC035428

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Improvements since the last inspection

Recommendations made at the last inspection have been suitably addressed or in the case of the residential redesign continue to be discussed.

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Improvements since the last inspection

All parts of the home to which children have access are as far as reasonably practical free from hazards to ensure their safety. Electrical installation work and fire safety work had been carried out and the accommodation fully complies with Fire and Rescue Services advice.

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Helping children to be healthy

The provision is outstanding. The management team ensure that full health histories are gained as part of the referral and introduction procedures. Health plans contain excellent details. Staff are fully familiar with health information and the up to date information allows health support to be coordinated efficiently. Information can be located quickly. Most of the young people require a detailed health and personal care response in order for them to enjoy their break at the home. The promotion of the young people's health and well-being is a key priority. Staff practice is effective and a quality service is provided.

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Helping children to be healthy

The home was providing short breaks on a rotating basis for 17 young people at the time of this inspection. The management of medicines, including controlled drugs, was being coordinated very well. Established systems ensure safe medicines handling. The Registered Manager monitors information closely through her statutory responsibilities. Monitoring processes are suitable to identified shortfalls. There is continuous reflection on practice and this allows new initiatives to be introduced and these shape future services. Needs arising out of cultural difference are addressed. Consultation with parents is efficient to identify equality and diversity matters.

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Helping children to be healthy

A clear health policy and procedural guidance has been produced. Staff practice follows this guidance. Staff receive training, to ensure that they have the skills to provide first aid, safe handling and administration of medicines. Developmental work has created a medicines administration recording system suited to young people receiving short breaks. Medication is handled safely between home, school and this unit.

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Helping children to be healthy

Health plans can only be changed following discussion with doctors and parents. No changes can be made to medication, unless written authorisation is provided by the young person's doctor. Parental permissions for emergency treatment and for administering medicines and first aid have been gained. Staff deployment is effective on a day-to-day basis in supporting health needs. Visits to dentists, doctors and opticians are usually coordinated by young people's families or carers, with whom they spend most of their time.

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Helping children to be healthy

Staff work with parents and carers to provide nutritional and healthy meals. The specific dietary requirements for each of the residents are outlined. Records show the meals that are eaten. The menus reflect the different cultures and expressed preferences of the young people attending this service. There are no outstanding recommendations highlighted within environmental health department reports.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. 5 of 10 Inspection Report: SC035428 Arrangements for staff recruitment, complaints, safeguarding children, bullying and behaviour management are handled well and ensure that young people feel listened to and protected. Safeguarding policies are made clear and staff practice is reflective of the procedural guidance within these policies. No concerns were highlighted throughout the course of this inspection. No notifications had been made to Ofsted between inspection. There have been no complaints between inspections. No safeguarding concerns have affected the home's operation. The response taken to a previous safeguarding matter was managed particularly well. Safe and transparent practice is demonstrated in all the above areas. Reporting protocols are followed. The young people are being looked after safely.

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Protecting children from harm or neglect and helping them stay safe

The management team and staff at this home have established good partnership arrangements with parents and carers. Consultation and communication is effective. Signed agreements underpin all the work undertaken. A suitable framework of support keeps young people safe.

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Protecting children from harm or neglect and helping them stay safe

Comprehensive risk assessments are produced to highlight the concerns and vulnerability of the young people. Agreed behaviour management and preferred handling strategies are produced. Staff practice incorporates parental wishes on how their children need to be cared for. Staff have proved to be competent between inspections, in supporting young people's needs. All staff receive behaviour management training.

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Protecting children from harm or neglect and helping them stay safe

Suitable safeguarding and complaints information is provided for the young people and their parents. Staff utilise picture exchange communication systems as well as picture and word association to help young people's comprehension. Staff have received child protection training, in order that they can respond appropriately to allegations or suspicions of abuse. Policy and procedural guidance established at this home is consistent with local safeguarding team protocols.

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Protecting children from harm or neglect and helping them stay safe

The young people's privacy is respected within the routines operated. Due to the nature of some of the young people's needs, intimate care tasks are required and these are done in an appropriate and respectful manner. Guidance on intimate personal care for young people with disabilities, includes administering medication and bathing routines. Appropriate staff training is provided for young people requiring staff help when moving and handling support is needed. Plans clearly outline the methods and techniques to be used.

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Protecting children from harm or neglect and helping them stay safe

A coordinated response is evident to security, health and safety. Servicing schedules and certificates relating to fire precautions, electrical and gas installations and appliance testing are held. A compliance letter from the Fire and Rescue Services confirms the home meets fire regulations. A detailed premises risk assessment has been produced. Practice fire drills are undertaken and recorded. Parents receive communications on fire safety procedures at the home. Letters outline individual approaches for each young person. General maintenance and improvements are being coordinated. No hazards were observed to young people's safety. Occupational health have had input to ensure the home remains fit for purpose. The accommodation layout continues to be reviewed when new referrals are accepted. A system has been set up to receive communications from the Central Alerting System for concerns associated with medical devices.

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Protecting children from harm or neglect and helping them stay safe

Checks carried out on the quality of staff vetting, recruitment and selection confirmed that a robust system is evident throughout the recruitment process. Suitable evidence including enhanced criminal records bureau (CRB) checks, references, application forms and records of 6 of 10 Inspection Report: SC035428 the interview are produced. Suitable vetting of visitors to the home is also undertaken, with identity checks being carried out before access is permitted.

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Helping children achieve well and enjoy what they do

The provision is outstanding. An initial assessment identifies the programmes of care and support to be followed. Comprehensive arrangements are outlined within placement plans designed to provide individualised support. The assessment of need specifies the levels of support required. Plans make it clear that staff can only contribute towards the overall arrangements due to the amount of time that young people actually spend at the home. Some young people only spend a few hours on an infrequent basis, whilst others attend for overnight stays regularly. Ongoing support is provided that enables young people to communicate their needs, wishes and concerns. Staff continue to develop different communication techniques.

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Helping children achieve well and enjoy what they do

Placement aims and objectives are well recorded. Plans are up to date and utilise a multidisciplinary response. The areas where the home has responsibility are coordinated efficiently. Parents receive regular reports on young people's progress. Staff have a good knowledge and awareness of residents needs. The individual and collective needs of the young people, can be met at this home through effective deployment of competent staff. Ongoing communication and consultation, ensures that parents and carers remain satisfied with the day-to-day arrangements in place. Regular meetings and statutory reviews take place, where changes can be made to arrangements. Many positive comments have been received on the home's operation. Staff are clearly making a difference to the quality of life that both young people and parents experience.

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Helping children achieve well and enjoy what they do

The young people's education is actively supported and promoted. Staff know the educational arrangements in place for each resident. Morning routines support attendance at respective schools. Communication books enable teaching staff, parents and the home’s staff, to provide consistent care in the three different settings young people move between. There is effective liaison with local authorities and teachers from respective schools. There is good continuity in the approaches being used to support needs. Telephone contact is frequent and good practice ideas are being shared.

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Helping children achieve well and enjoy what they do

Records seen show that financial resources are sufficient to enable the young people to take part in an ample range of age and ability appropriate activities. There is good access to community based recreation utilising a suitably adapted mini-bus. Planning for the vastly different needs of the young people, is acknowledged as being difficult. However, individual likes, needs and interests are known, allowing stimulating activities to take place. There is good photographic evidence on the activities being pursued.

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Helping children make a positive contribution

The provision is outstanding. The home's management team have established systems to manage placement arrangements. Supporting young people during short breaks at the home is very well coordinated. Aims and objectives are clear and these are closely linked to wider placement arrangements, being coordinated by other professionals and departments, working within a defined multi-disciplinary framework. 7 of 10 Inspection Report: SC035428 Placement planning arrangements are comprehensive. A detailed assessment of need is produced in consultation with parents. The religious and cultural needs of the young people are reflected in written plans. These allow children to be cared for in accordance with parent's wishes. The management team work hard to ensure placements are safe, focused and consistent with other plans. Staff possess good knowledge and understanding of each young person. It is clear that staff and the management team make a difference to the quality of the young people's lives.

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Helping children make a positive contribution

Practice at this home is pro-active and fully embraces the Every Child Matters framework, that forms part of the government’s vision to improve children’s services. Cultural identity continues to be promoted.

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Helping children make a positive contribution

Records produced provide a permanent overview of the time that each resident is at the home. Referrals are matched to staff's skills and experience. The home's management team ensures compatibility between the needs of young people on different nights, weekends and school holiday periods. Risk assessments support the decision making framework, when managing groups of young people. Referral and introduction procedures are well thought out, to establish a safe environment, for the children. Statutory reviews take place at appropriate intervals. Plans are adjusted when necessary, through discussions during these reviews. Key workers are committed to providing the young people with the best possible support and experience. Good outcomes are being achieved.

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Helping children make a positive contribution

There is good communication and consultation with families and this ensures all matters are dealt with promptly. Social workers are kept informed of pertinent issues. Many positive comments have been received from parents and young people on the quality of services being provided. Staff at this home have good relationships with the young people. More importantly communication channels with parents remain transparent. There is a panel of parents who can influence service delivery. Contact arrangements take into consideration the fact that young people spend time between their home address, schools and the children home. There is good communication between all three settings.

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Achieving economic wellbeing

The provision is good. Transition planning for the time that the young people move from the home to adult services is occurring but it is felt that support could be better coordinated. The Registered Manager is fully familiar with parents wishes and concerns when placements at the children's home end. The Registered Manager has identified some areas for improvement. Ideas and views are being discussed and this should allow the careful balance between parents comments and the strategic planning and objectives of both children and adults services to be taken into consideration. Transition plans are being developed through statutory review procedures. It is clear that the young people are gaining some of the life skills needed to support them into adulthood. Programmes operated, routines followed and placement planning are clearly linked. Residents engage with their plans with staff encouragement and support.

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Achieving economic wellbeing

The home is situated in a location that takes into account transport, education, health and leisure facilities. Shops and supermarkets are close by, making food shopping easy. The home is a detached bungalow with adequate parking. The staff are maintaining appropriate links with the local community. A charitable organisation continues to provide much needed support, resources and additional finances, to enable children to experience their short breaks at this home positively. 8 of 10 Inspection Report: SC035428 The home is safe, being decorated and furnished to a good standard. There is good space and resources to meet the needs of the young people. The design and layout of the home manages to retain a homely and comfortable feel. The use of the space and the different rooms is well thought out. Each room is suitably adapted and equipped to support young people with a disability. The home is clean and tidy throughout.

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Achieving economic wellbeing

Each young person has their own bedroom. Efforts are made to personalise bedrooms. Electrical equipment within bedrooms had been checked as safe. Moveable items that can cause dangers to some young people, are either removed or locked up. Staff are fully aware of the support required for individual children's night time routine.

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Achieving economic wellbeing

Bathrooms and toilet facilities comply with national minimum standards for children’s homes. Specialist equipment supports bathing routines. Suitable levels of privacy is afforded. Bathing and toilet facilities are shared between staff and residents. This situation is not ideal. Plans to improve staff facilities including an extension to the home had been previously considered.

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Achieving economic wellbeing

The home’s maintenance response has been efficient. A favourable first impression is gained when approaching the home. The home is maintained free from any observable hazards to young people's safety. Water temperatures are being regulated, to prevent any possibility of scalding. The boiler is regularly serviced. A rolling programme of refurbishment and improvements is evident. Recent upgrading to the playroom, lounge, and the soft play area in the secure rear garden has taken place. The garden area is a particular favourite of the young people.

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Organisation

The organisation is outstanding. Quality assurance systems demonstrate the management team are reflecting on the need to continually develop services in line with inspection recommendations, new initiatives and research. Practice is responsive and capable of providing high quality services for children with a disability. The efficient management of young people's needs has established excellent continuity between life at this children's home, respective schools and the home address. The Registered Manager has been instrumental in shaping many of the services at this home. These include, the efficient response to health and well being, effective consultation systems and excellent partnership arrangements with parents.

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Organisation

The promotion of equality and diversity is outstanding. Policy and guidance has been produced. Good training programmes are accessed. Many of the young people have profound disabilities, including communication difficulties. Individualised care planning is characterised by a clear commitment to establishing equality and fairness for everyone receiving a short break at the home. A diverse section of the local community is supported. The culture and ethos of the home is continually evolving through access to training and through efficient consultation with parents. Parents show their satisfaction in the services being provided. The service has been responsive in linking equality and diversity throughout the 24 hour curriculum of care and support being provided.

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Organisation

The home has a lengthy history of being managed efficiently. The Registered Manager is experienced, competent and fully qualified. Practice meets with the requirements of children's homes national minimum standards and associated regulations. The staff team have skills to support the specific needs of the young people. This staff team possesses a vast amount of 9 of 10 Inspection Report: SC035428 experience. The competencies and skills staff have continue to grow through access to training. Records show a good clarity of purpose in how staff are being managed. Induction and foundation training is provided. Supervision records are good and these are clearly linked to staff's personal development and appraisal.

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Organisation

Deployment of staff is good. The staffing structure has experienced few changes between inspections. The number of staff holding National Vocational Qualifications level 3 exceeds the desired 80% target. Each shift has a nominated team or shift leader. Rotas demonstrate that staffing levels are being maintained. Staff are clear about their roles, balancing their work so that the individual and collective needs of the young people are met whilst ensuring that the necessary administrative tasks are undertaken.

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Organisation

Staff have relevant written guidance, policies and procedures to support their practice. The home's statement of purpose provides good information in accordance with regulations. Aims and objectives as well as the philosophy of care are outlined. Records are easy to access within the office area. Staff use the guidance to ensure a consistent response to meeting residents presenting needs.

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Organisation

The home provides a safe and stable environment. Checks are in place to monitor the home’s operation. Reports are maintained in-house and are made available to those permitted to read them. These reports are forwarded to Ofsted in line with a new protocol. The home's management team have a team plan outlining how the home's operation will be maintained. There is good use of self evaluation. This is evident within the detailed information provided to Ofsted in advance of this inspection.

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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): • ensure transitional arrangements between children's and adults services are managed effectively (NMS 6.2 & 6.6) • advise Ofsted when the review and residential redesign of children with a disability services is to be completed. (NMS 28.1) 10 of 10 Inspection Report: SC035428

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