Children's Home run by The Rose Road Association in Southampton

SC042446 Unique reference number 12 August 2009 Inspection date Brian Mcquoid Inspector Key Type of Inspection

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30 September 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 8 Inspection Report: SC042446

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Brief description of the service

The service is a respite unit that offers short breaks for up to 12 children and young adults with severe learning difficulties that may include physical disabilities and additional health problems. It is run by a registered charity which provides support and information services to children, young adults and their carers throughout the area. The service is available to children and young adults, of both sexes, aged between two years and 25 years. The unit consists of two purpose built residential areas located within a modern purpose built complex that also contains a school and the offices of the charity. All those using the service are subject to a full pre-admission assessment aimed at identifying their care needs. This information is then used by a respite panel to determine if the service is able to meet their specific needs.

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Summary

The unit has a caring and committed staff team who know the young people they care for extremely well. Young people are happy to stay at the unit, they are treated with respect as individuals, receive a good standard of individualised care, and are suitably protected from harm. The staff group are well trained, operate well as a supportive team, and receive good support from the unit manager.

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Summary

The unit provides a child-centred environment which is suitably safe and secure, and which is well equipped to meet the needs of the young people being looked after. Links with external agencies in relation to young people's health needs are particularly good and ensure those with complex health needs are cared for appropriately. Arrangements at the unit for the management of medication are excellent.

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Summary

Current levels of staffing are frequently not meeting the prescribed staffing profile for the unit and there is an over reliance on the use of agency workers. This is concerning for the staff group who are under increased pressure as a result.

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Summary

The inspection was carried out on an unannounced basis and the unit was inspected against all of the key National Minimum Standards for children's homes. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The unit now has a registered manager, the process of approval having been completed by Ofsted since the previous inspection.

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Helping children to be healthy

The provision is good. During their stay at the unit young people are provided with a varied and healthy diet. Fresh produce is used as much as possible and fresh fruit is available at all times. There is a choice at mealtimes and young people are encouraged to try different foods. There is a good awareness of special dietary needs associated with both allergies, and religious and cultural needs. There is however no written record of these available within the main food preparation area. Young 4 of 8 Inspection Report: SC042446 people are able to access the kitchen areas to prepare snacks and drinks, and staff provide support at mealtimes for those who need it. Staff are trained in food handling and hygiene.

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Helping children to be healthy

There is good provision for identifying and addressing the health needs of young people accessing the unit. Parents retain primary responsibility for meeting young people's routine health needs, however there is a significant number of young people with varied and complex health conditions. Thorough assessments ensure all health related information is obtained prior to a young person visiting the unit, and comprehensive care plans identify how specific health needs are to be met. There are very good links with external health professionals, staff are trained to undertake specialist health tasks, and the unit is well equipped with specialist equipment.

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Helping children to be healthy

Provision for the management and administration of medication within the unit is excellent and provides adequate safeguards for the welfare of young people. A dedicated medication room and specialised medication trolleys ensure secure storage, and meticulous records provide a clear audit trail of all medication. Additional spot checks are also carried out. All staff are trained in medication administration, shift leaders and assistant unit managers only assume responsibility for medication during each shift, and the process is witnessed throughout by an additional staff member. There are currently no written individual protocols for the administration of medication to young people.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Staff protect young people's dignity and privacy at all times while providing necessary supervision. The great majority of young people stay in single rooms while at the unit and are able to spend time alone in their room. Confidential records are stored securely and staff ensure the confidentiality of information is maintained. Complaints procedures are provided for parents, and records show that all complaints received have been satisfactorily resolved. Complaints information does not currently include the contact details for Ofsted. A small number of young people are able to express their views verbally, and others have access to a complaints procedure utilising symbols. The majority however depend upon staff advocating for them. Staff at the unit have an intimate knowledge of the young people they care for and are able to communicate with them effectively, being able to detect if they are unhappy for any reason.

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Protecting children from harm or neglect and helping them stay safe

There is good provision at the unit for ensuring young people are well protected from harm. Staff possess a sound understanding of safeguarding and have annual child protection refresher training. There have been no child protection related incidents at the unit. Respite programmes are drawn up with due consideration to the compatibility of groups and staffing ensures good levels of supervision at all times. Bullying type behaviours are not a concern at the unit.

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Protecting children from harm or neglect and helping them stay safe

Young people are happy at the unit, with staff adopting a positive approach to ensure they enjoy their stay there. Clear and consistent boundaries are applied within a child-centred and supportive environment, staff know the young people extremely well and manage any challenging behaviour effectively. Currently staff do not use sanctions or physical interventions to manage behaviour. This may change and guidelines for recording do not presently accord with the standards.

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Protecting children from harm or neglect and helping them stay safe

The unit provides a safe and secure environment for young people. Fire drills are held regularly and tests and checks of fire safety equipment are carried out as required. Comprehensive risk 5 of 8 Inspection Report: SC042446 assessments are devised for individual young people, however, individual venues visited are not subject to written risk assessments. In addition, there is no checklist in operation prior to trips being undertaken.

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Protecting children from harm or neglect and helping them stay safe

The procedures for the recruitment of new staff are in accord with the standards, provide adequate safeguards for the welfare of young people, and are being rigorously applied.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. Individual support is provided for young people according to their needs, with some being staffed on a one to one basis. Staff are acutely aware of young people's needs and abilities, and while providing support when necessary also encourage young people to be as independent as possible. Young people are valued and treated with respect as individuals. The ability of staff to spend individual time with young people is regularly constrained by problems associated with staffing.

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Helping children achieve well and enjoy what they do

Young people are supported to attend school while staying at the unit, including some being transported to and from by staff. Working relationships are good with some schools attended by young people, but not with others. Staff report attending educational reviews when possible and recognise the importance of consistency of approach with young people in both settings. In some instances young people use electronic communication aids and electric wheelchairs while at school but do not bring them to the unit. Art and craft materials are available within the unit and interactive whiteboards are to be fitted shortly. There is currently no computer access for young people.

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Helping children make a positive contribution

The provision is good. Clear procedures ensure detailed information on individual young people is gained prior to them visiting the unit. Comprehensive care plans address identified need, and a period of assessment determines if the unit is an appropriate placement and the level of staffing required to meet the young person's needs. Plans are subject to regular review, and staff contribute to the statutory reviewing process for young people, where it currently applies. In practice the great majority of young people do not attend their reviews, with parents and staff representing their views.

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Helping children make a positive contribution

Communication with parents of young people is good. There is a communication book which travels with the young person between home and the unit, and parents are welcome to visit their child while staying. All new referrals to the unit are subject to a gradual introductory process sensitive to their needs. This includes any number of visits before being considered ready for an overnight stay. Young people leaving are provided with a photographic album of them participating in activities during their stays.

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Helping children make a positive contribution

The great majority of young people at the unit experience communication difficulties to varying degrees and use a variety of communication methods. Staff are able to communicate effectively with young people and provide them with choice as much as possible in areas of their daily lives. 6 of 8 Inspection Report: SC042446

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Achieving economic wellbeing

The provision is good. Staff support young people moving on to adult service placements should they be requested to, and young people are encouraged and supported to be as independent as possible during their limited time at the unit. There are also regular trips to community activities which contribute to young people's social development.

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Achieving economic wellbeing

Accommodation at the unit is of a good standard overall, well maintained and well suited to the needs of young people being cared for. The one exception to this is the garden area which is in a state of neglect, and the internal quad area where a drain cover presents a potential risk. The majority of young people are accommodated in single rooms with just two rooms being shared occupancy. Young people are able to bring personal items with them when they come to stay. The unit provides an environment which is safe and secure, which is child-centred, and which is made as homely as possible. The whole unit is wheelchair accessible and there is a variety of specialist facilities equipment to accommodate the needs of young people with disabilities.

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Organisation

The organisation is satisfactory. The unit has a detailed statement of purpose provided for parents and placing authorities. The statement does not contain details of the unit's staffing policy. Young people undertake a very gradual introductory process which includes visits from staff, the use of a photo album depicting the unit, and visits to the unit prior to overnight stays commencing. This process is sensitive to the needs of individuals and gives each young person the opportunity to become familiar with the setting and its staff before staying.

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Organisation

Promotion of equality and diversity within the unit is satisfactory. Young people are treated equally according to their needs, and their religious and cultural needs are addressed within care plans. A very diverse range of needs is catered for within the unit, gender issues are addressed appropriately, and there are good opportunities provided to access community facilities.

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Organisation

The staff group at the unit operate very effectively as a team and are very competent in meeting the needs of young people they care for. They are provided with appropriate training in order to meet the specific needs of young people, and operate in a caring and child-centred manner. There is however a concern that staffing levels are not able to be maintained without a reliance on agency workers. The assistant unit managers frequently work directly with young people instead of being supernumerary, and there have been occasions when more than 50% of staff on one side of the unit have been agency workers. These factors place a burden of extra responsibility upon permanent staff, as well as the potential for the care of young people to be compromised. Staff receive good support from the unit manager but not all staff are currently receiving formal supervision at the required intervals.

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Organisation

There is effective provision for the monitoring of the unit's overall operation and the welfare of individual young people. Regulation 33 visits take place at the required intervals, communication between staff is good, staff meetings are held regularly, and the manager maintains a good overview of events within the unit. 7 of 8 Inspection Report: SC042446

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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

14 September 2009 ensure that where necessary, young people have written protocols, agreed by parents and professionals, for the administration of medication. (Regulation 21) 14 September 2009 ensure that the use of any sanction or physical intervention is appropriately recorded in accordance with the standards. (Regulation 17) 1 October 2009 ensure that the unit's garden area is maintained to a satisfactory standard. (NMS 24) 14 September 2009 ensure staffing levels are always consistent with the unit's staffing policy, and are sufficient in number, experience, and qualification to meet the needs of young people attending. (Regulation 25) 14 September 2009 ensure no more than half the staff on duty in either side of the unit at any one time, are from an external agency. (Regulation 25)

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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): • maintain profiles of young people, including details of special dietary needs, within the main food preparation area for the unit's cook to access. (NMS 10) • ensure the unit's complaints procedures contain the contact details for Ofsted. (NMS 16) • instigate a check list for staff to use prior to trips out, and draw up risk assessments specific to venues visited. (NMS 26) • endeavour to improve working relationships with schools attended by young people. (NMS 14) • work to ensure no young person is disadvantaged by a lack of access to individual communication and mobility aids while staying at the unit. (NMS 7) • assess the risk posed by a drain grating within the internal courtyard area, and take any action identified as necessary. (NMS 26) • ensure the unit's staffing policy is contained within the statement of purpose. (NMS 30)

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Recommendations

• ensure all staff are provided with formal supervision at the required intervals. (NMS 28) 8 of 8 Inspection Report: SC042446

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