Children's Home run by Surrey County Council in Surrey

SC370703 Unique reference number 11 May 2009 Inspection date Kerry Fell Inspector Key Type of Inspection

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18 August 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 10 Inspection Report: SC370703

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Brief description of the service

The home was registered in May 2008 and is a large detached purpose built service, which offers short breaks to a maximum of 22 children and young people aged between five and 18 years. The service is currently registered for 15 children and young people in three apartments (houses). The home plans to open the fourth apartment in September 2009.

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Brief description of the service

The service is designed for children and young people with a learning disability and specifically for those on the autistic spectrum, who attend a specialist school, which is located on the same campus. The accommodation at the home is on two floors, accessible by both stairs and a lift and divided into in four separate apartments, with each apartment offering services to children within a specific age range. Each apartment has a living room, kitchen-diner, bathroom and toilet facilities and the required number of individual bedrooms and are appropriately furnished. Communal facilities include a laundry, small garden and transport. The service can access a range of facilities within a local specialist school, including outdoor play areas, a hydrotherapy pool, sensory rooms, soft play areas and the art room. Staff are provided with appropriate facilities including office space, sleeping-in accommodation, separate toilets and a locker room.

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Summary

This was a key unannounced inspection, and the home's second inspection since registration. All of the key national minimum standards were inspected. The home's response to actions and recommendations made at the last inspection were also reviewed. The home continues to provide a good service to children and young people, and the individualised care is commendable. 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

The home is still in its first year of registration, and continues to grow and develop.

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Improvements since the last inspection

Action has been taken to ensure that copies of recruitment checks are forwarded to the home. This is not always successful, however, the manager can easily obtain copies of recruitment checks from the human resources department where all personnel files are centrally held.

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Improvements since the last inspection

Action has been taken to meet the three recommendations made at the last inspection. Some schools have not forwarded the personal education plans and statements of special educational need following the home's request.

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Improvements since the last inspection

Reference forms observed during the inspection contained greater detail.

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Improvements since the last inspection

Staff supervision notes are now available for inspection if necessary, however, separate records of all supervision sessions are held on the staff training and supervision files.

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Helping children to be healthy

The provision is good. The home has a commendable approach to healthy eating and meal preparation. The staff actively support the children and young people to prepare their own meals and snacks, where 4 of 10 Inspection Report: SC370703 appropriate. Step-by-step programmes are produced for each child and young person using words, pictures and Makaton symbols; they include the recipe, a shopping list and the utensils needed to prepare the meal. The young people met during the inspection were each preparing a different meal.

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Helping children to be healthy

The home has a rolling six-week menu to ensure that meals are varied, and staff promote healthy eating. Wall displays in the kitchen areas support the promotion of healthy eating and include information and pictures about how healthy each meal is.

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Helping children to be healthy

Healthy snacks and drinks are available, and the children and young people are encouraged to help themselves.

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Helping children to be healthy

The children and young people attend the home for short breaks, therefore, the promotion of health remains primarily with the parents and carers. However, the person centred plans completed by staff complete include elements of health planning, and detail how staff are to support the child or young person to meet their health, clinical and medical needs. These are supplemented by the 24 hour plans which offer a more detailed programme of how staff are to offer support with health and personal care.

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Helping children to be healthy

Appropriate records are kept of accidents and injuries.

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Helping children to be healthy

The home is proactive in seeking support from the community teams with regard to supporting health and personal care needs. Action is being taken to promote sexual health and the formation of appropriate social relationships in a manner that the children and young people understand.

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Helping children to be healthy

An easy to follow medication policy is in place, which has been updated since the last inspection. Robust action has been taken to ensure that practice and policy reduces the risk of medication errors, with sound audit systems supporting staff practice. Medication is held securely. All medication is logged in and out of the home, and staff seek authorisation from GPs for any changes to medication. Practice observed reflected the home's policy.

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Helping children to be healthy

Staff confirmed that they had attended first aid training, and there is always an identified first aider available on shift.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Policy and guidance is available with regard to privacy and confidentiality. Staff demonstrated sound practice with regard to maintaining dignity and respecting children and young people's wishes.

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Protecting children from harm or neglect and helping them stay safe

A corporate complaints procedure is available, and this is reflected in the statement of purpose. Printed leaflets are also available. Children and young people are also offered support from the National Young Person's Advocacy Service (NYAS). Although the three step procedure provides for a local resolution in the first instance and then an independent investigation, it does not specifically identify how complaints about the registered persons should be made or dealt with. The manager stated that they had not received any complaints since the last inspection. 5 of 10 Inspection Report: SC370703 The home takes appropriate action in order to safeguard children and young people. Staff know how to respond if they believe a child or young person has been abused, and are supported by the multi-agency training provided. Surrey Multiagency Safeguarding Board procedures are held by the home, and Surrey County Council makes their procedures available via the staff

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Protecting children from harm or neglect and helping them stay safe

intranet. Staff also have access to a range of training documents. The home has supplemented safeguarding procedures with an internal policy. The policy provides staff with guidance on how to respond to concerns about abuse, but focuses specifically on evidence of physical abuse.

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Protecting children from harm or neglect and helping them stay safe

Sound policies are in place with regard to countering bullying and the absence of a child without permission. Both internal policies are supported by Surrey County Council policies and statements. There have been no recorded incidents of bullying or absence of a child or young person.

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Protecting children from harm or neglect and helping them stay safe

The home has an ethos of positive reinforcement in relation to behaviour management, and uses natural consequences rather than sanctions. However, the policy held does not fully reflect the home's ethos. Staff attend training in 'Positive Options' management of actual or potential aggression, which is the behaviour management and physical intervention system used by Surrey County Council. Staff demonstrated a good understanding of when this intervention should be used, and only once a management of actual or potential aggression risk assessment had been completed for the child or young person. Staff complete incident forms where accidents, injuries or incidents of inappropriate behaviour or risk occur, these are linked to records of sanctions and physical intervention. Only two incidents of intervention had been recorded since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

The home has good regard for health and safety. Certificates are held to demonstrate that gas safety and portable appliance testing is undertaken. Fire safety is monitored by an external agency, and fire evacuation procedures are displayed around the home.

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Protecting children from harm or neglect and helping them stay safe

Surrey County Council human resources department manage the recruitment of employees. The manager has access to recruitment checks via a database and evidence of these checks and their outcome is forwarded to the manager for approval. Although not all information is held on personnel files within the home, the manager can obtain this information easily.

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Helping children achieve well and enjoy what they do

The provision is outstanding. The home champions the use of person centred planning for the children and young people, and are commended for the way in which the home plans visits around the individual needs of the children and young people.

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Helping children achieve well and enjoy what they do

Staff complete a person centred plan and a 24 hour plan for each child and young person specifically detailing how staff are to support the child or young person during their stay. The mix of children and young people that attend the service together is planned well. The manager pays particular attention to the specific needs of the children and young people, and where necessary will arrange for smaller numbers of children and young people to stay in the houses.

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Helping children achieve well and enjoy what they do

Specialist communication systems are used throughout the houses. Children and young people who attend the home for short breaks are diagnosed with learning disabilities and/or are diagnosed with autistic spectrum disorders. Staff are knowledgeable about the importance of structured environments and predictability. Staff use 'TEACCH' structured environment 6 of 10 Inspection Report: SC370703 techniques to support the children and young people. Timetables and programmes are created for each young person using words, pictures, symbols and photographs.

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Helping children achieve well and enjoy what they do

The home uses a coordinator system rather than a keyworker system. Coordinators are responsible for ensuring children and young people's files are well maintained, and to plan activities in advance of the child or young person's visit to the home. Following a request from parents and carers the staff are producing timetables that will be sent to the children and young people prior to their visit, and will let them know who will be supporting them and what they will be doing during their visit.

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Helping children achieve well and enjoy what they do

Although the promotion of education remains with parents and carers the home has regard for the children's education and preparation for adulthood. Staff continue to request copies of educational reviews, individual education plans and statements of special educational need.

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Helping children achieve well and enjoy what they do

Children and young people attend the home either during the week as part of an educational programme with a local specialist school, or on the weekend as part of a social care referral. In both cases the children and young people work towards educational and developmental goals which form an essential part of their stay at the home.

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Helping children achieve well and enjoy what they do

Staff liaise closely with staff from the school.

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Helping children achieve well and enjoy what they do

Activities that promote personal, social and educational development are offered both inside and outside of the home. Social activities and outings are planned during the weekends and school holidays, and a good range of age appropriate toys and games are available.

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Helping children make a positive contribution

The provision is good. The manager visits each child and young person to assess their individual needs, and collect the information needed to develop the person centred plans. A range of records are maintained for each child and young person, which form their placement plan. Specific support needs are identified and recorded within these plans. These are detailed documents and in some cases even the manner in which staff are to offer support and what they are to say to the child or young person is included. Any religious and cultural needs are identified during the assessment visits.

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Helping children make a positive contribution

Staff complete daily reports and monthly reports on the child or young person's visits to the home. The home has not yet been open for a full calendar year, however, staff have been involved in the annual review processes when these have taken place.

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Helping children make a positive contribution

Contact with parents and carers is promoted, even though children and young people only attend for short lengths of time. Records of this contact are held.

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Helping children make a positive contribution

Children and young people are not admitted into care when they visit the home, however, all short breaks are planned carefully with the children and young people and their families.

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Helping children make a positive contribution

The manager is liaising with the local authority and the National Autistic Society to look into how the home can support young people who are moving onto adult services or onto independence. 7 of 10 Inspection Report: SC370703 Children and young people are supported to make decisions during their stay through the use of choice boards and specialist communication systems. Questionnaires are sent to the children and young people and to their parents and carers at the end of their educational programmes at the home.

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Achieving economic wellbeing

The provision is good. The children and young people that attend the home are not looked after by the local authority, therefore, the promotion of independence and moving onto adulthood remains with parents and carers. However, the manager is taking action to look at how the home can develop the moving on (aim higher) agenda further.

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Achieving economic wellbeing

Many of the activities undertaken by the children and young people whilst staying at the home develop social and independence skills.

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Achieving economic wellbeing

The home continues to be maintained to a high standard, however, over the 10 months that it has been in use the manager has identified areas and facilities that do not fully meet the needs of the children and young people. Action has been taken to resolve these, and work continues to develop the home further.

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Achieving economic wellbeing

The home continues to provide excellent communal space and external space, with the children and young people being able to use the private garden area and the external spaces of the nearby school, outside school hours.

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Achieving economic wellbeing

Single bedrooms are provided for children and young people. The home cannot guarantee that the children are able to stay in the same bedroom at each visit, so an extensive range of bedding, lamps and other items are available to personalise the bedrooms. Staff support the children and young people to choose the items that they want for their bedrooms on the first night of their stay.

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Organisation

The organisation is good. The home holds a clear statement of purpose that meets the requirements of the children's homes regulations. Individualised children's guides are produced for the children and young people, and the home has produced a large display in the entrance area that provides an overview of the home's statement of purpose.

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Organisation

The promotion of equality and diversity is good. Staff have regard for the specific cultural, religious and support needs of the children and young people. The home has an inclusive approach to the specific communication systems used by the children and young people, with Makaton symbols and photographs being used throughout the home.

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Organisation

The home is still recruiting to a full staff team, however, the home's ethos is to adapt the staffing levels to meet the needs of the children and young people attending. Staffing levels are high, and in some cases breaks are planned where three members of staff are supporting one or two children or young people. 8 of 10 Inspection Report: SC370703 Each house has a team leader and deputy which ensures that staff are available to deputise in the absence of a manager. Staff teams provide a good mix of experience and qualifications, and a good gender mix. Care bank cover is available to cover staff absence.

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Organisation

Shift planning is completed carefully, and activities are planned in advance.

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Organisation

Staff speak highly of the support and training offered, and records demonstrate that staff are completing core training, including first level child protection, fire safety, autism, and physical intervention. The ratio of staff who have completed National Vocational Qualifications at Level 3 has fallen since the last inspection because the home is continuing its recruitment drive. Evidence of regular supervision is available, and staff confirmed that they receive sufficient support, supervision and appraisal.

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Organisation

Sound auditing systems are in place. Monthly visits with regard to Regulation 33 of the children's homes regulations are completed, and detailed reports are available at the home. These are circulated to staff.

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Organisation

Children and young people's records continue to be well maintained and are stored securely.

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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

15 June 2009 ensure that the home has a complaints procedure that fully meets the children's homes regulations (Regulation 24) 15 June 2009 expand the internal safeguarding policy to cover all types of abuse (Regulation 16 (1),(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): • review the behaviour management policy so that it better reflects the home's ethos (NMS 22). 9 of 10 Inspection Report: SC370703

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