Children's Home run by Dorset Council in Dorset

SC032163 Unique reference number 13 May 2009 Inspection date Stephanie Omosevwerha Inspector Key Type of Inspection

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14 October 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 11 Inspection Report: SC032163

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Brief description of the service

The provision is a purpose built children's home that is run by a local authority. It is situated in a residential area of a seaside town. The site where it is based also accommodates a home for older people and a sheltered housing development. The home is able to accommodate up to 14 children and young people of either sex, aged between four and under 18 years of age who have a learning disability including those who have additional more complex or challenging needs. The majority of children receive respite care but the home is also able to support children requiring longer-term care. In addition the home provides a day care service for up to 10 children during weekends and school holiday periods. The home is arranged into four living units with a fifth area used for day care. Each unit has single bedrooms, bath and toilet facilities and lounge/diners. Two units have a kitchen. One unit has been specially adapted for children with

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Brief description of the service

physical disabilities. Other facilities include a sensory room and an art/craft room. The home is built around a quadrangle which is used as a play area and has additional garden areas around the outside of the building.

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Brief description of the service

There were 11 children accommodated at the time of this inspection.

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Summary

This was an unannounced inspection of the home, which took place over one and a half days, focussing on all the key national minimum standards. There were three good practice recommendations made at the last inspection which were also followed up.

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Summary

The home provides a good standard of care to children and young people accommodated there. The home is well run with tasks delegated between senior management to ensure the smooth operation of the home. Staffing levels are high ensuring children receive individual support and attention. Children's needs are recognised and plans are in place to address them. Staff have a good knowledge of individual children and can clearly explain how they work with them. Staff are confident in managing challenging behaviour and receive external support for further guidance and intervention. Children live in a safe environment and sound working practices ensure their wellbeing. Good systems are in place for monitoring care to maintain and improve practices and achieve better outcomes for children during their stays.

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Summary

Three recommendations from the previous inspection relating to staff supervision, staff training and transport have not been fully met and therefore, are carried forward in this report. An additional recommendation regarding annual appraisals for staff has been made at this inspection. 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

There were three recommendations made at the previous inspection concerning suitably adapted transport, staff supervision and National Vocational Qualification (NVQ) training.

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Improvements since the last inspection

The home are still investigating suitable forms of transport and how this is to be provided, so this recommendation is carried forward in this report. 4 of 11 Inspection Report: SC032163 All staff are receiving formal supervision, however, this is still not taking place at the recommended frequency of one session per month, so this recommendation is carried forward.

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Improvements since the last inspection

An increased number of staff have achieved a NVQ at level 3 qualification, with further staff enrolling on the course. This has had a positive effect in increasing staff skills and confidence and shows a strong commitment to working towards achieving the target of 80% qualified staff.

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Helping children to be healthy

The provision is good. Children are provided with a balanced diet that meets all their dietary requirements. Their nutritional needs are noted on their care plans, including any likes or dislikes, allergies or other specialist requirements. Catering staff are employed to prepare evening and weekend meals and staff are able to make additional snacks if necessary. Children eat in their individual units which helps to promote meals as social occasions. Staff encourage children to participate in meal times, such as laying and clearing tables, according to their ability and understanding. Children's skills are also developed by the promotion of good table manners and support to eat as independently as possible. For example, using verbal prompts instead of actual physical assistance.

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Helping children to be healthy

Children's good health is promoted by plans that identify both routine and specific health needs and ensuring appropriate services are provided. For children who access the respite service the responsibility for attending health care services, such as dentists and opticians usually remains with the parents or carers. Staff liaise closely with parents of longer stay residents to ensure their wellbeing. Children benefit from therapeutic input from a multi-agency team providing intensive support sessions in the home, which include individual work with children and guidance to staff.

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Helping children to be healthy

There is good provision for the management and administration of medication in the home, particularly when dealing with medications coming in and out of the home for children staying for respite. Medication is kept securely and accurate records are kept of all medication, treatment and first aid given to children. Clear arrangements are in place to address the use of prescribed, non-prescribed and homely remedies. Staff are trained in the use of first aid and demonstrate a detailed knowledge of individual children's medicines and what they are for, any contra-indications and what to do in an emergency situation. A designated senior member of staff takes responsibility for administering medication on each shift.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Children's privacy is respected as is consistent with good parenting and the need to protect the child. Staff promote children's dignity and are sensitive when offering personal care support. Clear procedural guidelines are in place so staff understand their responsibilities, such as access to case records and how to deal with and share confidential information. Written information is stored securely ensuring stringent levels of confidentiality are maintained.

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Protecting children from harm or neglect and helping them stay safe

The home encourages an open ethos where children, staff and family members are able to raise concerns and feel confident they will be listened to. Staff respond to minor issues promptly to avoid them becoming more serious complaints. A procedure is in place to deal with more formal 5 of 11 Inspection Report: SC032163 complaints, which are appropriately recorded including detailing the outcome. These are monitored to ensure satisfactory operation of the complaints procedure.

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Protecting children from harm or neglect and helping them stay safe

Children are kept safe by clear procedures for responding to child protection concerns. Staff receive training in child protection and have a sound understanding of their responsibilities to report any suspicions or concerns. Excellent links are established with the Local Safeguarding Children Board and staff work jointly with other agencies to ensure children are properly protected.

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Protecting children from harm or neglect and helping them stay safe

Staff are aware of the need to support children and promote a culture that teaches everyone the importance of mutual acceptance and respect. Because of the nature of the children accommodated bullying is normally identified as part of a much wider pattern of behaviour. For example, children exhibit behaviours, such as hair pulling, biting or scratching and may target whoever is there at the time rather than any specific child. Staff are aware of the need to monitor and intervene if necessary, employing behaviour management strategies to effectively keep children safe.

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Protecting children from harm or neglect and helping them stay safe

Appropriate policies and procedures are in place concerning children that are absent without authority. The risk of this happening in practice, however, is extremely low due to security measures in the home and community, risk assessments that identify any potential issues and high levels of staff supervision. Records confirm no incidents have taken place.

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Protecting children from harm or neglect and helping them stay safe

Children's behaviour is effectively managed by staff encouraging children to develop socially acceptable behaviour. Staff have a good knowledge of children's individual behaviour and respond with acceptable, constructive measures when dealing with potential challenges. Staff complete team teach training to ensure they are confident in de-escalation and physical intervention techniques. In addition, multi agency support is provided in the home, which provides intensive intervention to individual children and advice and guidance to staff. Physical restraint is only used as a last resort to ensure children's safety or prevent injury to others. The manager fully reviews the use of restraint and sanction in the home to ensure they are appropriate, identify any patterns of behaviour and help inform future practice.

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Protecting children from harm or neglect and helping them stay safe

The home provides a safe environment that is suitably maintained to ensure the welfare of children, staff and visitors. A range of risk assessments are carried out to manage and minimise potential hazards to children both in the home and out in the community. Staff demonstrate an awareness of procedures and receive training to ensure safe working practices. Services and facilities are regularly checked and serviced.

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Protecting children from harm or neglect and helping them stay safe

Children are protected by robust recruitment procedures that include careful vetting and selecting of potential members of staff. A comprehensive application and interview process ensures only the most suitable staff are employed. Staff are aware of their responsibilities to monitor all visitors to the home in the interests of the safety and welfare of all children accommodated.

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Helping children achieve well and enjoy what they do

The provision is good. Children's individual needs are assessed and well met by the home. Care plans detail specific needs and give consideration to issues, such as religion, culture, racial origin and communication needs. Staff demonstrate a good understanding of individual needs and are able to describe 6 of 11 Inspection Report: SC032163 each child individually, explaining how they are working with them. Staff receive training in alternative forms of communication ensuring all children are listened to and encouraged to make choices. Pictures, signs and symbols are used throughout the home to enable children's understanding, for example pictures of staff on duty and evening tasks and activities. Good staffing levels ensure children have time for individual support and are able to access activities in the community. The home has links with a range of helping agencies to provide services to meet young people's needs and advocacy groups are used to support children and their families.

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Helping children achieve well and enjoy what they do

Children's education is actively promoted and supported. The home keeps accurate information about children's current education placements. Staff liaise closely with schools and have a particularly strong link with one local school where a staff representative attends the school's senior management team meetings once a month. This has greatly improved the consistency of working with children enabling a coordinated approach particularly designed to prevent children from needing out of county placements.

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Helping children achieve well and enjoy what they do

Children are encouraged to take part in leisure activities both inside the home and in their community. A good range of leisure activities are available in the home, such as games, DVD's, art and crafts. There are also several different areas of outdoor space providing opportunities for children to take part in ball games, trampolining, bike riding and gardening. The home does not have its own transport, which can sometimes limit activities particularly for children needing more specialist transport. However, there are local parks and amenities that are within walking distance of the home and there is transport available that the home can borrow or hire at weekends and during holiday periods to alleviate this problem to some extent.

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Helping children make a positive contribution

The provision is good. Children's needs are clearly assessed in a written placement plan detailing all aspects of each child's care and how their needs will be met in the home. This information is readily available to staff and reviewed and updated by key-workers on a regular basis. Staff demonstrate a sound understanding of children's care needs including supporting children with communication difficulties. Families and carers are also consulted about children's needs ensuring consistent approaches between home and respite care. Statutory reviews are held at the required intervals with parents, staff from the home, social workers and other involved professionals attending and contributing to the process.

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Helping children make a positive contribution

Children's contact with their families is maintained and encouraged. The home operates an open door policy and welcomes visitors. Any restrictions to contact arrangements are clearly recorded and well known by staff who supervise contact when this is necessary. Parents are able to make phone contact with the home and communication books are used to inform them about children's stays.

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Helping children make a positive contribution

Children are able to move into and leave the home in a planned and sensitive manner. Some excellent work has been done recently for children moving in and out of the home, which involved staff from both old and new placements working together and multi-agency meetings held to support the moving process. This included giving staff from the new home the opportunity to work with the young person in placement prior to the move. A booklet was also set up in an accessible format to support the process and explain it in a way that the young person could understand. 7 of 11 Inspection Report: SC032163 Children are encouraged to share their views and opinions about the home and care practices give them opportunities to make everyday choices. Signs and symbols are used throughout the home to help children's understanding of things, such as meals, staffing and daily routines. A recent consultation was undertaken with families and other stakeholders to gain their views

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Helping children make a positive contribution

about the service and inform future development.

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Achieving economic wellbeing

The provision is good. Children receive care that helps to prepare them for and support them into adulthood. One unit in the home is specifically set up to help young people work on their independent living skills. Kitchen facilities are provided so they can undertake activities such as preparing drinks and snacks and using a washing machine. Children are given appropriate support and supervision with tasks according to their skills and abilities. Staff liaise with other agencies as appropriate to ensure a smooth transition when young people are moving on. This included a recent example of staff undertaking shifts at an adult resource which residents had moved on to in order to help with the moving process.

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Achieving economic wellbeing

Children are accommodated in a well maintained home that is suitable for its stated purpose, which is to provide respite and long stay care for children with learning disabilities. Although the home can accommodate up to 14 children, it is designed into four separate living units so children can be looked after in smaller, more manageable groups. This also means in the main that children being provided with long term care can be accommodated separately from children having respite to prevent them being unnecessarily disrupted. All children are accommodated in single rooms, which can be personalised to make them feel more homely. There is a good range of outdoor spaces providing children with opportunities for physical activities. Facilities are all on ground level and appropriate equipment, such as hoists and wheelchairs, are provided to ensure children with physical disabilities can be accommodated.

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Organisation

The organisation is good. Information about the home is available to parents and other interested parties in an up-to-date Statement of Purpose. This contains all the statutory required information as well as providing a guide to the home's aims and how children will be cared for. A children's guide is in place in an accessible format using symbols and staff take time to verbally explain the document to try and enable children to understand the information.

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Organisation

The home has a clear management and team structure and staff know which assistant manager is responsible for their support. Regular management and team meetings are held to ensure information is effectively cascaded to and from all members of staff. There is always a senior member of staff on duty to offer assistance and advice and staff say they feel well supported in their daily practice. Staff have opportunities for formal supervision, although this is not currently meeting the recommended frequency of one session per month. Formal appraisals of individual performance, which should be undertaken annually, are also overdue.

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Organisation

Children are cared for by a mixed staff team, with a diverse range of backgrounds and experience. Staff are employed effectively in the home making sure their skills are used appropriately. For example, some staff feel more confident working with children who exhibit challenging behaviours. The home is committed towards having a qualified workforce and several members 8 of 11 Inspection Report: SC032163 of staff have achieved a level 3 NVQ since the previous inspection, although the 80% target is still not met. This has had a positive effect on staff confidence and skill level and encouraged other members of staff to undertake the qualification. Staff have opportunities to take other courses that are linked to the children's needs, for example, sign along, manual handling and equality and diversity.

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Organisation

Children benefit from flexible staffing arrangements that are assessed according to individual need. This ensures there are always sufficient numbers of staff on duty to provide children with a good level of care and interaction. The home has maintained a relatively stable staff group and staff work in allocated units to enhance consistency of care and ensure staff get to know the children well.

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Organisation

The promotion of equality and diversity is good. Children's care plans fully assess their individual needs and staff have a good knowledge of children ensuring they receive a personal service. There is a commitment to improving services by the provision of books, toys, equipment, activities and services to meet the needs of all children including those from minority ethnic communities. Staff training and resources in the home ensure different communication needs can be met, for example, the use of pictures, symbols, and sign along. There is a mixed staff team, which is employed effectively to allow gender sensitive care wherever possible. The environment promotes inclusion by presenting information in accessible and attractive formats for children, including images to represent different cultures. Children are encouraged to access their local community for a range of social and leisure activities.

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Organisation

There are good systems in place to monitor children's progress in the home. The registered manager regularly reviews all aspects of the service to ensure standards are being maintained and improved where necessary. Monthly monitoring visits are carried and form part of the quality monitoring system. Feedback questionnaires are also used effectively to obtain parents and stakeholder views to inform future service development.

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Organisation

Children's individual case files are confidentially stored and provide an accurate record of their needs, developments and progress during the time they are accommodated in the home.

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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): • consider providing suitably adapted transport to support children in their leisure activities. (NMS 15.11) • carry out supervision of all care staff at the recommended frequency of one session each month. (NMS 28.2) 9 of 11 Inspection Report: SC032163 • ensure all staff have their performance individually and formally appraised at least annually by their line manager. (NMS 28.7) • maintain a focus on staff development and training including working towards increasing the number of qualified staff in the home. (NMS 29.5) 10 of 11 Inspection Report: SC032163

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