Children's Home run by London Borough of Hillingdon in Hillingdon

SC068789 Unique reference number 3 June 2009 Inspection date Tola Akinde-Hummel Inspector Key Type of Inspection

p.1

18 November 2008 Date of last inspection .

p.1

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.

p.2

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

p.2

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.

p.3

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: SC068789

p.3

Brief description of the service

The home is a purpose built respite provision which opened in January 2007. The unit is run by a local authority. The home provides respite/short break care for children and young people of either gender who have disabilities and are aged from seven to 18 years of age.

p.4

Brief description of the service

The home is close to local shops and has good transport links. On the day of inspection four children/young people were in the home having respite stay and tea visits. The children and young people were observed but did not participate in the inspection.

p.4

Summary

This unannounced full inspection looked at the key standards under all the Every Child Matters outcome groups. Young people enjoy short breaks in a home that caters for their individual needs. Children and young people come from very diverse backgrounds and are supported in all aspects of personal and practical care whilst encouraging independence. Young people are encouraged to eat a healthy diet, take regular exercise and participate in creative play and rest. Work with external agencies such as health, education, and social services has improved; enabling young peoples needs to be better met. The home has undergone a period of adjustment due to a change in management. Whilst this was difficult initially, the staff have positively embraced these changes and value the increased opportunity to learn and improve. Relationships with families are positive and work is ongoing to further improve documentation and consultation

p.4

Summary

with children and young people. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

p.4

Improvements since the last inspection

The manager was asked to record the time that fire drills take place in the home. Records show that the timings of fire drills is now consistently recorded. The home was also asked to provide more explicit details of individual responsibilities on shift plans. This has also been completed. In addition more suitable bathroom mirrors have been provided.

p.4

Helping children to be healthy

The provision is good. Children and young people are provided with adequate amounts of healthy, varied and balanced meals.

p.4

Helping children to be healthy

The recently introduced food theme evenings encourage young people to explore meals from other cultures. Staff responsible for planning menus and ordering food are aware of the specific dietary needs of all young people using the service. The home has adopted a healthier snack programme which has been explained to the children and young people. Mealtimes in the home are a social affair. Children and young people enjoy coming together. This is reflected in their general behaviour at the table.

p.4

Helping children to be healthy

Detailed information is available about the children and young people's health needs. Both primary and secondary health care provision is available to children and young people as required. Staff are provided with specialist training to ensure they meet health care needs and 4 of 8 Inspection Report: SC068789 provide more consistency to children and young people in their care. Children who use wheelchairs and have visual impairments are provided with equal attention, stimulation and support as more physically able children.

p.4

Helping children to be healthy

Children and young people often bring medication with them for the duration of their short break. One member of staff records all medicines that enter the home. Another member of staff is responsible for checking these records to ensure they are correct. This level of verification and documentation has not been applied to medication leaving the home at the end of a short break. Staff have recently been retrained in the administration of medication. Staff are expected to demonstrate their competence and to show awareness of their responsibilities in this area. Health and medication records give good direction particularly where young people's conditions are life-threatening.

p.5

Protecting children from harm or neglect and helping them stay safe

The provision is good. Children and young people have their confidentiality maintained and their personal information stored securely. Support with personal care provided by staff is undertaken discreetly and sensitively. Children and young people can expect their privacy to be respected as long as it is safe to do so.

p.5

Protecting children from harm or neglect and helping them stay safe

The home has a complaints procedure which parents and carers and young people are familiar with. There has been one informal complaint since the previous inspection, this was handled appropriately. The home considers complaints to be a positive learning experience which provokes discussion and actions to improve the service. The home has received a number of compliments from professionals and families of the children and young people they care for. These compliments suggest that the staff team are supportive and committed to the children they look after.

p.5

Protecting children from harm or neglect and helping them stay safe

Staff in the home have undertaken child protection training and are clear about how any allegations or suspicions should be reported. The mandatory training programme ensures that refresher training is provided. The home enjoys a good relationship with social workers from the children with disabilities team. This makes communication on child protection issues more straightforward. The manager, head of care, one member of staff in rotation, attend the children with disability panel meetings.

p.5

Protecting children from harm or neglect and helping them stay safe

Children and young people can be confident that staff take a lot of care to ensure that they enjoy their break. Careful planning, detailed risk assessments, discussion with significant individuals keeps bullying to a minimum. A significant number of children and young people receive one-to-one support. This is dependent on their needs. If any bullying is identified staff explain clearly why this is not acceptable and seek to change behaviour. If necessary staff will ensure that particular children do not receive short breaks at the same time.

p.5

Protecting children from harm or neglect and helping them stay safe

Detailed knowledge of children and young people, and high levels of supervision protect children from being absent without authority. The home has a policy and procedure to deal with such situations. Clear risk assessments reduce the opportunities for this to occur.

p.5

Protecting children from harm or neglect and helping them stay safe

There is a system in place in the home to notify relevant authorities of any significant events that take place. Such notifications are not high in number and demonstrate the home's ability to protect children and young people in their care. 5 of 8 Inspection Report: SC068789 Children and young people enjoy adequate bathrooms and washing facilities. However the hot water in all en suite toilets, the communal bathroom and shower room release water that is too hot for a very short period of time.

p.5

Protecting children from harm or neglect and helping them stay safe

The home now has a better system for recording fire drills and fire tests and ensuring that all health and safety responsibilities are met. Equipment in the home used by disabled children and young people is regularly tested. This reduces the risk of accident and injury during tea visits and overnight stays.

p.6

Protecting children from harm or neglect and helping them stay safe

Staff who work with the children and young people are thoroughly checked to ensure they do not pose a risk to their health and safety. Any visitor to the home is prevented from entering if they do not have any connection with the home and are unable to provide any form of identification. The home's security system prevents automatic access to the building. All staff are employed through the Borough's human resources procedure. This includes references and enhanced criminal records bureau checks( CRB) which are renewed every three years.

p.6

Helping children achieve well and enjoy what they do

The provision is good. Children and young people are encouraged to express their needs and preferences. This assists staff in the home to support them appropriately. In addition, the home encourages children and young people to learn skills such as setting the table, making drinks and tidying up after an activity. Children and young people are encouraged to work and play together. The home has a link worker system. This does not restrict children and young people seeking support from any member of staff during their short break. Young people observed were happy and relaxed and able to communicate with all staff members on duty.

p.6

Helping children achieve well and enjoy what they do

The home is developing its relationship with the main schools that children attend. This helps to provide some consistency for children and young people in relation to communication, managing behaviour, promoting independent living skills and supporting their education. Parents and carers understand that the support their children receive at home and in school will be the same during their short break. Staff attend school reviews at least twice a year. This provides an opportunity to hear how children and young people get on at school and to provide additional information about how they are progressing during their break.

p.6

Helping children achieve well and enjoy what they do

Children benefit from a well resourced home that provide a wide variety of activities. All activities are risk assessed. Staff are open to ideas from parents about other toys which aid stimulation. Staff know what children and young people like to do in their spare time and activities during their break are personalised. The home allows children and young people to explore their environment, relax and be creative at individuals or in a group.

p.6

Helping children make a positive contribution

The provision is good. Improved placement plans covering all aspects of children and young peoples needs have been introduced. The plans are developed in consultation with parents and young people. These plans are written in a way that highlights their abilities. The plans outline what action staff need to take to support children and young people to develop their confidence and independence. 6 of 8 Inspection Report: SC068789 Children and young people participate at their reviews. The home provides reports for the reviews which highlight if the care plan is working and if any amendments need to be considered.

p.6

Helping children make a positive contribution

Children and young people maintain contact with their parents during their break if this is required. At all other times children live with members of their families.

p.7

Helping children make a positive contribution

The home has re introduced residents meetings with young people. The home does not consistently record how it communicates with young people who are non verbal to ascertain their views. In addition, a wishes and feelings book has been developed which has proved popular. Parents and carers feel able to speak to staff and the manager about the service provided and this is done informally. The home has also started using a ladder of events with children and young people. This incorporates activities of their choice. The purpose of the ladder is to help them understand the sequence of events during their break. Staff take time to explain and listen to children and young people.

p.7

Achieving economic wellbeing

The provision is good. Staff work hard to ensure that preparation is done to assist young people leaving the service. The home aims to make this transition as seamless as possible. Preparation includes improving independent living skills and visiting future placements. The home reassures parents and young people about where they will be moving onto and celebrates their departure positively.

p.7

Achieving economic wellbeing

All young people have a leaving party and a leaving tea. This means that young people are not taken by surprise when they leave children's services and enter adult services.

p.7

Achieving economic wellbeing

The home is a purpose built unit with ceiling track and floor hoists. All four bedrooms have an en-suite toilet with hand washing facilities. Children and young people benefit from a well equipped garden suitable for wheelchair users, an art room and sensory room. The dining and lounge areas are well furnished and comfortable. A new room has been created for older children to relax in. The home is inviting, bright and airy, clean and well maintained.

p.7

Organisation

The organisation is good. The home has not revised the Statement of Purpose and this remains relevant. This assists parents and carers to decide if the service is suitable for their children.

p.7

Organisation

The needs of children and young people determine the number of staff available on each shift. If extra staff are required during peak periods this is provided. All staff are aware that the head of care deputises when the manager is absent. Shifts are planned and staff are clear about their roles and responsibilities during each shift. Observations of the staff rota demonstrate the shifts are well organised. Members of the team organise rotas, giving staff the opportunity to take responsibility for the different aspects of the running of the home.

p.7

Organisation

The staff team receive mandatory training. Some staff have completed their NVQ level 3 and newer members of staff are in the process of completion. Although not seen during this inspection, staff say that they now receive regular supervision which they find helpful. Staff also have performance and development meetings to assess their competencies, training needs and areas for development. This has been reintroduced by the new manager. 7 of 8 Inspection Report: SC068789 The head of care has organised whole team training on total respect and medication and there are plans to organise further training. This will include training on sexuality and training on story sacks.

p.7

Organisation

Staff claim that team meetings are an open forum where new ideas are encouraged and practice issues are discussed in detail.

p.8

Organisation

The promotion of equality and diversity is good. The home has a consistent approach to ensuring the diverse needs of the children and young people they support are met. Consideration is given to race, culture, sexuality, physical limitations and religion. Examples of this are evident in care plans, decoration and equipment around the home, training and the knowledge of staff.

p.8

Organisation

The manager completes an audit of care practice once a month. These audits are random and give a good indication of how the home is meeting the national minimum standards. In addition the home has regulation 33 visits. The manager completes monthly monitoring of records such as sanctions, restraints, complaints, accidents and incidents. This means that children and young people are supported by staff who regularly review their practice.

p.8

Organisation

Children and young people's records in the home are detailed and informative. The new files are more orderly and easy to follow. However the records are not consistently signed and dated by parents, link workers and managers.

p.8

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.

p.8

Due date Action Standard

3 August 2009 provide opportunities for children and young people to give their views about the running of the home, in particular reference to methods of non verbal communication used. (regulation 15) 30 June 2009 obtain the information specified in Schedule 3 in respect of each child, in particular ensure care plans and risk assessments are signed and dated (regulation 28)

p.8

Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • consider keeping a record of medication returned with children and young people following a short break(NMS 13.10) • check the hot water system for any potential faults, paying particular attention to taps in the en-suite toilets, bathroom and shower room (NMS 25.8). 8 of 8 Inspection Report: SC068789

p.8