Children's Home run by Nottinghamshire County Council in Nottinghamshire

SC036737 Unique reference number 8 December 2009 Inspection date Caroline Brailsford Inspector Key Type of Inspection

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26 January 2009 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 8 Inspection Report: SC036737

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Brief description of the service

This is a local authority children's home providing a short break service to children and young people in the local area. In addition to the short breaks, which are provided in two areas in the home, there is a residential service for six young people. All three areas are separate. All of the young people have physical disabilities and some have complex health care needs. All areas provide attractive and accessible communal rooms, play areas, bedrooms and bathroom facilities.

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Brief description of the service

The home is a large house, set in pleasant extensive grounds, in a rural area close to a nearby town where there are shopping and recreational facilities.

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Summary

This key inspection was unannounced and all key national minimum standards were inspected. Each of the outcome areas have been given a judgement rating. Being healthy, enjoying and achieving, staying safe, and organisation are judged as outstanding. Economic wellbeing and positive contribution are judged as good.

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Summary

The home provides an outstanding service to the young people who live there. Strengths include the robust nature of safety procedures for the young people. The staff team are also caring towards the young people. They are experienced, well trained and provide very good quality care. There is also an exceptionally high value placed on establishing the wishes, views and feelings of all the young people who use the service, whatever their communication method. This also helps to keep the young people safe. The management of the home continues to ensure that each area of care to individuals is well monitored. This ensures that a consistent excellent quality of care is delivered. The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

There were no actions or recommendations made from the last inspection to the home.

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Helping children to be healthy

The provision is outstanding. Young people help to choose and enjoy the food in the home. Individual needs and preferences are encouraged and very well provided for. Young people's needs differ tremendously, with some eating and some receiving all of their nutrition via a gastrostomy tube. Staff are highly skilled and knowledgeable about individual information to ensure that all the young people receive a nutritious diet.

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Helping children to be healthy

Young people receive exceptionally good support from staff with regard to their health and emotional wellbeing. This ensures that all aspects of health needs for individuals are met as far as possible. The overall health care is decided by qualified nurses who make assessments, then train and delegate tasks to the care staff. This works very well and ensures that young people's health needs are safely met. A high staffing ratio also supports this work and staff ensure at all times, that the young people are comfortable and as well as they can be. 4 of 8 Inspection Report: SC036737 All staff members have completed a first aid course, the result being that there is always a first aider in the home should the young people need assistance with a medical issue. The storage, handling and recording of medicines is very complex but well organised and safe in the home. Young people can receive household medicines only after instruction from their doctor, ensuring

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Helping children to be healthy

that their safety is protected. Protocols for emergency medication are approved by the nurses and the young person's own doctor. Despite these protocols being very detailed and lengthy, the staff have a very good understanding of what should happen and when. On one protocol viewed the wording was not as clear as it could be, leaving room for potential error. However the risk to the young person was very minimal as the information was presented very clearly in the risk assessment also.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. Young people enjoy a high level of privacy and dignity in the home in all aspects of their daily living. They are highly respected by staff. This helps them to feel safe and protected.

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Protecting children from harm or neglect and helping them stay safe

The complaints procedure is easily accessible to young people and their own communication method is established and very well understood by the staff. This enables all young people to express any issues that they may have more easily, ensuring safety and welfare. Each complaint is kept in a central file, with the outcome clearly recorded. Each piece of documentation evidences the outcome and the response is clear, quick and professional. Young people say they can talk to staff if they have concerns or worries. Staff have a clear understanding and commitment to implementing the home’s anti-bullying policy and ensuring and enabling young people to express any issues they may have.

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Protecting children from harm or neglect and helping them stay safe

The safety and welfare of the young people has a very high priority in the home. Each has their needs and risks identified in documents. These provide detailed and exceptionally clear information to staff about how risks can be minimised as far as possible. The risk assessment documents which cover all aspects of safety, work very well in practice and help to keep the young people as safe as possible.

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Protecting children from harm or neglect and helping them stay safe

The staff at all levels understand and are clear about what they should do if there is a safeguarding issue. Also close liaison with social workers ensures that all safeguarding information is shared properly. Staff are very knowledgeable about safety issues for disabled children in residential care and are vigilant about all the young people's safety.

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Protecting children from harm or neglect and helping them stay safe

The staff have built up very positive relationships with the young people and see them in an extremely positive light. Their needs and behaviour are well understood by the staff and there is an emphasis on behaviour as a means of communication. The staff's approach to behaviour is extremely positive, both in their language and methods. They have completed training and are competent in diffusing situations to try to avoid the use of physical intervention and there have been no such events in the home for several years. Staff try to find the root of the problem and understand how in turn, these issues impact on the young people emotionally and on their behaviour.

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Protecting children from harm or neglect and helping them stay safe

The registered manager ensures that the building is safe for the young people, staff and visitors. Fire drills have taken place regularly as have tests on all fire equipment in the building in line with the requirements of the fire authority. Staff know what to do should there be a fire. 5 of 8 Inspection Report: SC036737 Inspection of the gas, electric and portable appliance testing are all up to date and this ensures the safety of the staff, visitors and young people using the building.

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Protecting children from harm or neglect and helping them stay safe

There is a recruitment system in the home which maintains good levels of safety for the young people. This includes criminal records bureau checks at enhanced level, proof of identity and references prior to employment. Although the actual personnel record is kept centrally within the personnel department, the registered manager ensures that she views and keeps her own checks. This helps to ensure that all staff and visitors to the home are safe to work with the young people.

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Helping children achieve well and enjoy what they do

The provision is outstanding. The staff are extremely familiar with the individual needs of the young people, and there is a robust system for ensuring that they receive the relevant personal support in the home. The staff have forged good relationships with the young people and know then very well. The high level of communication work that takes place ensures that for each young person, they can express their needs, whatever their disability and therefore be supported well.

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Helping children achieve well and enjoy what they do

All young people receive education in the community and those young people who are using the short break service continue their usual school placement during their stay. Transport is well organised so that this can be facilitated. Staff are good at liaising with schools so that a consistent level of care can be offered to the young people. A school diary, communication aids, and photos are all used to help the young people to communicate their own achievements.

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Helping children achieve well and enjoy what they do

Leisure is covered in individual care plans and it is evident that the leisure needs of the young people are very well met. Staff have ensured that the young people have leisure opportunities according to their needs. A high staffing ratio allows for trips to be facilitated. In the home, there are exceptionally good facilities so that all young people whatever their disability can properly engage in activities. For example there is a new large sensory garden with water features, fragrant plants and a story chair. There is also a very well equipped sensory room with extensive equipment so that all the young people can enjoy the experience.

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Helping children make a positive contribution

The provision is good. Young people are cared for well in this home by staff who provide consistent excellent quality care. Individual care plans and risk assessments provide a comprehensive assessment of need and inform staff about what to do on a day-to-day basis. The care planning system is well understood by staff and ensures that there is streamlining from the point of admission through the review meetings and into everyday life. There are regular statutory reviews and young people are actively encouraged by the staff to contribute. There are regular changes in the needs of the young people but the systems in place for the exchange of new information are very good.

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Helping children make a positive contribution

Young people are supported when they move into the home and staff make them feel very welcome and try to settle them in, in a supportive way. The admission is managed at a pace that is suited to the individual. There is a rigorous risk assessment process which ensures that compatibility is managed safely. 6 of 8 Inspection Report: SC036737 Arrangements for young people to maintain contact with families is good and parents and carers are informed about progress. The majority of parents asked commented that this is a strength of the the staff.

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Helping children make a positive contribution

Staff demonstrate that they place great value on the views and opinions of the young people and spend a lot of quality time with them to ensure that their views can be established. This ensures that all the young people have a voice.

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Achieving economic wellbeing

The provision is good. Young people are encouraged by staff to develop their independence, providing them with confidence and skills that will support their future economic wellbeing.

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Achieving economic wellbeing

Resident young people live in a well-maintained and comfortable home. The short break areas are also very pleasant and well suited to the needs of the young people who use them. The house is well furnished, decorated and presents a homely environment for young people. Resident young people have their own rooms which are very well personalised.

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Organisation

The organisation is outstanding. The Statement of Purpose is current and up to date. It is regularly updated and reflects the work that is taking place. The management and organisation of the home is professional and delivers very positive outcomes for the young people. The registered manager is a very effective manager and knows the needs of the young people well. She has a broad knowledge of operational issues in the home and manages the staff in a way that is extremely competent. Efficient systems are in place to ensure good information management and to scrutinise the quality of the care being delivered. A strong management team communicate effectively to ensure that any patterns or trends are addressed and that the care is monitored to a high standard.

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Organisation

The promotion of equality and diversity is outstanding and the staff ensure that each young person is seen as an individual and is treated as such.

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Organisation

Young people continue to benefit because there is a highly skilled, caring and competent staff team working at the home. They are very enthusiastic and motivated by their enjoyment of working with young people and watching them progress. The team work well together and possess the skills that they need to look after this client group well. They know the needs of individuals well and how they should be met, ensuring that exceptionally good quality care is delivered. There are enough staff on duty at all times to provide safe care and staff have opportunities to spend quality time with the young people.

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Organisation

Staff benefit from a high level of support and receive regular time with their manager to discuss any issues that they might have. There are robust processes to ensure that staff are properly inducted and well trained. There is a good appraisal process allowing staff to access training which is over and above the national minimum standard. 7 of 8 Inspection Report: SC036737

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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

There are no recommendations. 8 of 8 Inspection Report: SC036737

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