Children's Home run by Portsmouth City Council in Portsmouth

SC037588 Unique reference number 16 July 2009 Inspection date Lynda Mosling Inspector Key Type of Inspection

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29 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 9 Inspection Report: SC037588

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Brief description of the service

This home is registered for a maximum of six young people between the ages of five and under 18 years. It is owned by a city council and provides short-term placements for young people with learning difficulties and physical disabilities. It is situated on a busy main road with good links into the local city.

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Brief description of the service

The home is a large, detached house that has been adapted over the years to provide ground floor accommodation for young people with complex needs. The home has a range of specialist equipment, including hoists and assisted baths. The first floor is used for offices and the staff bathroom.

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Summary

This unannounced key inspection assesses all of the key National Minimum Standards for Children's Homes.

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Summary

The home provides good care to young people, on a short term basis, with a range of complex needs. The staff are very experienced and confident and receive good training and support from health and education colleagues. Thorough assessment of need is undertaken prior to placement and this informs the care plans for each young person.

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Summary

Parents and carers are very involved with the plans for delivering care and keep the home informed about their child's needs.

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Summary

Consultation with young people happens on a day to day basis but the home is still developing processes to evidence the way that young people's views are considered.

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Summary

No actions are required as a result of this inspection but there are three good practice recommendations. All of the outcome areas are judged as good. 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 has been continual improvement in the morale of staff as the group have become more confident in their abilities. Joint working with local schools has improved, especially with regard to young people's preferred methods of communication. This has improved the consistency of approach to young people. The allocation of placements are planned more appropriately to ensure better matching of young people in placement together. Training arrangements for staff required to deal with complex health needs have been put in place successfully. The garden is now a safe and interesting place for young people to spend time alone or as a group.

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Helping children to be healthy

The provision is good. Young people enjoy a variety of nutritious meals that are planned to take account of their individual preferences. Allergies and special dietary needs are well catered for. Mealtimes are sociable occasions with staff and young people interacting constantly. There is choice at each 4 of 9 Inspection Report: SC037588 meal and young people are able to use their preferred method of communication to make their choice.

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Helping children to be healthy

Very thorough information is gathered before a placement is agreed to enable the young person's health needs to be met. There is involvement of the parents and medical colleagues to ensure staff are given the correct information and training to provide good care to young people with a range of complex health needs. Appropriate equipment, such as hoists, are in place to help with care and mobility. As the placements are short term the parents or main carers of the young people remain responsible for the health care of the young people when they are not in the setting. Staff are confident and competent at caring for the young people's health needs in a way that ensures their dignity.

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Helping children to be healthy

Medication arrangements are good. The policy and process of administering medication has been developed with the help of medical colleagues. There is a safe and simple procedure that is well understood by all staff and works well in practice. Staff are trained and competent in administering medication and are aware of the effects of the drugs on the young people. Records are accurate and up to date and checked by senior staff on a daily basis. Appropriate advice is sought when necessary from specialist health colleagues. The health of young people is considered daily and reported to family and schools as required.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people are treated with respect and dignity and have their personal care needs undertaken in private. Information about young people is kept confidential and due consideration is given to who can share this information.

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Protecting children from harm or neglect and helping them stay safe

Information about the complaints procedure is provided at the first involvement with the family and is repeated at reviews to ensure it is well known. Young people's views are elicited using their preferred means of communication. Staff respond quickly to any signs of discomfort or distress and address them straight away. Whilst staff support the right to complain there has been no specific training for them in handling complaints. There have been no formal complaints made since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Staff confirmed that they have received training in child protection procedures and have a clear understanding of their responsibility to keep young people safe. Staff feel that safeguarding training relating specifically to young people with limited communication skills and personal care needs would be beneficial. Thorough risk assessments are undertaken for each young person to highlight their vulnerabilities, with suggestions of how to minimise the risk of harm.

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Protecting children from harm or neglect and helping them stay safe

There is a good corporate anti-bullying policy but the young people do not generally understand the concept of bullying. Any potentially damaging behaviour between young people is stopped through distraction or engagement of one of the young people in activities elsewhere. Improved matching of young people being cared for together has helped keep incidents of targeted behaviour to a minimum.

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Protecting children from harm or neglect and helping them stay safe

Whilst there is a clear missing persons policy and procedure the home has not needed to use it. Careful risk assessments and resulting action has enabled the staff to keep young people from going missing. The doors to the main road are kept locked and good levels of staffing when on outside activities ensures young people are observed at all times to ensure their safety. 5 of 9 Inspection Report: SC037588 Young people are helped by staff to develop acceptable behaviour within the boundaries of their understanding and capabilities. Repeated reminders and demonstration of what is expected is used to good effect. The main sanction used is to remove the young person from the other young people for a short period until the incident is forgotten. Staff use their knowledge of the young people to avoid triggers that may result in challenging behaviour.

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Protecting children from harm or neglect and helping them stay safe

The home has good fire safety procedures and undertake regular tests and evacuations. All staff are aware of the action to take in case of fire, although the records of staff fire training are not clear. All of the communal and sleeping areas are on the ground floor and there is easy access to the grounds. Risk assessments, health and safety and food hygiene records are all up to date. Equipment and transport is maintained appropriately to ensure the safety of staff and young people. All visitors to the home are required to knock and explain their purpose before being shown in.

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Protecting children from harm or neglect and helping them stay safe

Recruitment procedures are designed to keep young people safe. The central recruitment records have been inspected and judged as good. The manager ensures that all staff working in the home have up to date checks and undergo a period of induction before working directly with the young people.

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Helping children achieve well and enjoy what they do

The provision is good. There are individual care plans for each young person that clearly identify the support required. This support is provided with patience and affection by the care staff who are keen to help young people reach their potential. Although there are a large number of young people cared for during the course of a year the staff carefully prepare for each placement to make their stay as enjoyable as possible. A key worker is allocated for each young person. These develop close relationships with the young person and their family and ensure staff are kept up to date about any changes of support required.

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Helping children achieve well and enjoy what they do

As a respite care facility placements are seen as a break for the young people with less emphasis on homework and school attainment. The staff are, however, in close contact with the schools and provide transport to and from the home. They also meet with teachers to discuss communication methods and pass on general information about the young people to help them provide the best care possible. Staff are involved in reviews of the young people and help with transition plans where possible.

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Helping children achieve well and enjoy what they do

Activities are planned around the needs and interests of the particular group of young people being cared for at any one time. Young people are able to experience group and individual activities depending on their choice on the day. Activities away from the home include trips to the local parks, special events and drives around the local area. After school young people have the opportunity to relax, watch television, play in the garden or attend local youth clubs. Young people enjoy their time at the home and relate well to the staff.

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Helping children make a positive contribution

The provision is good. Young people's needs are well assessed prior to placement and are then reviewed on an ongoing basis. The care plans detail how the individual should be cared for and give clear instruction to the staff about how to best deal with the young person's needs. The manager is good at ensuring 6 of 9 Inspection Report: SC037588 the placements are appropriate and within the competency of the staff group. There is evidence that the parents are involved in agreeing the care plans but little on file to demonstrate young people's views. The home has recently purchased a computer system that uses pictures and symbols to be used for that purpose.

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Helping children make a positive contribution

Reviews take place on a regular basis and involve staff, social workers, medical professionals and teachers. The timing and venue of the reviews have been made more flexible to ensure young people can attend where appropriate. This demonstrates an improvement in the desire to include young people's views. The independent reviewing officer sometimes visits the home to observe the young person in placement prior to the review. This ensures that the reviewing officer has more understanding of the young person's needs and how these are met by the placement.

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Helping children make a positive contribution

As a respite service the young people are only briefly cared for away from home. Contact and communication with parents is frequent. Staff demonstrate respect for parents of the young people and often develop good relationships. Parents have recently helped the providers make a DVD about the services provided to young people in the city. They are keen to provide feedback to the staff and this is welcomed by the service.

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Helping children make a positive contribution

Staff use their extensive knowledge of the young people to gain their views. Consideration of preferences and choices is seen as vital by the staff although the recording of this is quite sparse. Young people are seen to be given choices wherever possible and to have any actions affecting them explained by staff. A group of young people and staff have recently been brought together with the aim of involving young people in decisions about service delivery. The home now display photographs of the staff highlighting those currently on duty to help young people understand the roles and responsibilities.

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Achieving economic wellbeing

The provision is good. The transition for young people moving on to adult services can be difficult but the manager and staff work closely with the social worker to ensure they help prepare the young person for any move. Whilst most of the young people cared for will not achieve total independence the staff ensure they are helped to be as independent as possible. They do this by adhering to care plans that identify skills to be learnt and not taking over practices that the young people can manage themselves. Close contact with the parents ensure that the staff have some idea of the long term plans for each young person and help them work towards these.

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Achieving economic wellbeing

The home provides good quality accommodation for the young people. The living accommodation has comfortable seating, a pleasant dining area and a domestic style kitchen. The garden is designed for use by young people with disabilities, has soft flooring and safe play areas. There are specially adapted swings and a range of equipment young people can safely use on their own. There are some sharing rooms in the home and good consideration is given to who should share these. Friendships and quality of interaction are taken into account when allocating sharing rooms. Sometimes only single rooms are used, according to the needs of the young people. Each room is prepared prior to the young person's arrival to ensure the correct equipment is available and the young person's preferred bedding is used. This provides a warm welcome to the young people and minimises anxiety at being away from home. 7 of 9 Inspection Report: SC037588

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Organisation

The organisation is good. A statement of purpose is in place. This has been recently reviewed and accurately describes the service offered. All of the information required by the standard is included. It is very well written and is available to parents, social workers and other interested parties. The manager is working on a pack for young people but this is not yet available. Young people and their family are visited by senior staff as part of the assessment process and this provides an opportunity to share information about the setting. Introductory visits are offered to all prospective placements.

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Organisation

The staff are all very experienced in caring for young people with disabilities. They are competent and confident carers and demonstrate a well developed knowledge of the needs of each young person. There are good arrangements for cover when the manager is away from the home. Staff are clear about the roles and responsibilities of the managers, these having recently been re-written. The manager is well qualified for his role and supports training for all staff. Over 90% of the care staff have achieved the National Vocational Qualification in Care at level 3.

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Organisation

The promotion of equality and diversity is good. The staff are very good at identifying young people's individual needs and planning the service around those needs. There are no assumptions made about what the young people are capable of and the staff are keen to promote individual choices and interests. All of the staff are good advocates for the young people in their care and ensure they are treated fairly and with respect, both in the home and in the community. The council has a clear equality and diversity policy and staff confirm that this runs through all training and support provided. The manager is part of a strategic management group and promotes the need to allow equal access to services for all young people.

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Organisation

Staff work well together and there are good processes for handing over information at the change of shifts. This ensures all staff are aware of the changing needs of the young people. There are currently no staff shortages and the rota confirmed that an adequate number of staff are on duty at all times.

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Organisation

The service is responsive to the needs of the young people requiring care and is very child focused in its approach. Monitoring arrangements ensure that the service provides care as described in the statement of purpose. Feedback about the quality of care offered is welcomed and the home is working on a new quality assurance system to complement this.

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Organisation

Young people's files contain the information necessary to provide good and appropriate care to the young people. The information is updated at the start of each placement and there are efficient processes to ensure parents, carers and schools can pass on any relevant information. There is, as yet, little evidence of young people contributing to their records. Further information about the young person is available through the social work records.

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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. 8 of 9 Inspection Report: SC037588

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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 all staff receive training in the complaints procedure (NMS 16.6) • ensure all staff are provided with training in the prevention and recognition of abuse (including its recognition in non-verbal children). (NMS 17.8) • ensure young people's views and expressed opinions are sought and recorded. (NMS 8.3) 9 of 9 Inspection Report: SC037588

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