Children's Home run by Praxis Care in Leicestershire

SC032069 Unique reference number 15 December 2009 Inspection date Warren Clarke Inspector Random Type of 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: SC032069

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Brief description of the service

This is an independently operated children's home providing respite care, at any one time, for up to four children or young people with learning disabilities/physical disabilities, aged between six and 19 years. Four children were resident at the time of the inspection and one was visiting as a precursor to being resident at a later date. They all participated, either directly or indirectly, in the inspection.

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Brief description of the service

The home is a domestic bungalow and is set back from a main road of a suburban area. It is on a bus route and close to shops and other amenities. All facilities are on the ground floor and consist of four separate single bedrooms, large dining and sitting areas, sensory room and kitchen. The suitably enclosed outdoor area is equipped with appropriately adapted play equipment and a sensory garden. The house is decorated and furnished to a high standard and a child's or young person's bedroom is personalised on each occasion she or he is resident.

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Summary

This unannounced interim inspection focused on the home's performance against the key national minimum standards (NMS) in two outcome areas: staying safe and organisation. It also assessed whether, and with what effect, deficits identified at the last inspection were addressed.

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Summary

Over the current inspection period, the home has provided the children and young people with a high standard of short break care. Despite the absence of a permanent manager, management and leadership of the home and overall performance are strong. This has enabled children and young people with complex disabilities and heath problems to benefit particularly from the excellent social and recreational opportunities that the home provides. Some attention is, however, required in two areas: there continue to be occasional lapses in testing the fire alarm at the usual frequency and there is no certainty that all ancillary staff have been provided safeguarding training or appropriate briefing. 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

In response to deficits identified at the last inspection, the following actions have been taken: The record of menus is set out in sufficient detail to demonstrate that the children and young people are provided a suitable and varied diet. The fire alarm is tested weekly to ensure it remains operationally effective, but there are occasional lapses in the frequency of the tests. Promotional information about the home's complaints procedure now refers to Ofsted as the regulator. It also provides Ofsted contact details and makes apparent that complaints about the home may be directed to the regulator.

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Improvements since the last inspection

The home is operating with an almost entirely relevantly qualified permanent care staff team and the registered person has resolved to use only qualified relief staff in future to ensure the children and young people are always looked after by a high ratio of those with the right qualifications. Also since the last inspection the person managing the home has successfully completed a course leading to a validated qualification for those holding such a post. This 4 of 8 Inspection Report: SC032069 contributes to overall knowledge and skills and professionalism that underpins the children's care.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Care practices and the resources available in the home, give proper recognition to the children's and young people's high level of dependency and the need to preserve their privacy and dignity. Particularly care is taken to ensure that all intimate aspects of care are conducted in private and in ways that do not avoidably cause embarrassment or any compromise of the children's and young people's dignity. Each child or young person is allocated an exclusive bedroom when resident. These rooms are equipped so that any personal care assistance needed, such as with dressing, is conducted in private. Bathrooms and toilets are similarly equipped to promote the children's and young people's privacy and as much independence as possible. Staff are bound by a code of conduct which includes maintaining the confidentiality of personal information and in this regard, they act professionally. All records and other documentation with such

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Protecting children from harm or neglect and helping them stay safe

information are securely stored. Of particular remark is that the vast majority of staff have been employed at the home for a number of years thus the children and young people do not have a succession of new staff attending to their intimate care.

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Protecting children from harm or neglect and helping them stay safe

The home has a clear complaints procedure used as a formal means for children, young people, their parents or others to register any dissatisfaction about its the quality of service. The procedure meets all the requirements in relation to receiving, considering and reporting the outcome of complaints to complainants. In appropriate form, the complaints procedure is well promoted to all those with an interest in the home. For example, the text of children's and young people's version of the procedure is illustrated in formats relevant to their age and understanding. The manager and staff operate the home in an open way inviting feedback from parents and social workers about the quality of service. Staff are also alert to non-verbal responses of possible dissatisfaction from those children and young people who are not able to make their wishes and feelings known conventionally. These approaches ensure that any

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Protecting children from harm or neglect and helping them stay safe

concerns are dealt with at an early stage and may account for there being no complaints for some considerable time.

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Protecting children from harm or neglect and helping them stay safe

Staff are provided comprehensive information on the nature of abuse and a clear procedure for the event of any allegation or suspicion of it. This is combined with staff training in safeguarding children and aligned with safe caring practices to prevent abuse. For instance, staff do no isolate themselves when with any particular child. There are no current concerns about the children and young people who are completely at ease with staff and comfortable in the home's environment. Although the staff rarely have cause to work with the safeguarding children service, the home's child protection procedure has been validated as in accordance with those of the Local Safeguarding Children Board. There is, however, some uncertainty about whether all ancillary staff employed in the home have received child protection training or adequate briefing. It is necessary for all staff to complete such training or to have a sufficient

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Protecting children from harm or neglect and helping them stay safe

understanding of child abuse so that they are able to recognise it, contribute to its prevention and to respond appropriately to any concerns. 5 of 8 Inspection Report: SC032069 The children's and young people's disabilities and health problems limit their ability or inclination to bully others out of malice. Staff nevertheless remain alert, recognising that some children's disability causes them to behave in ways, which may impact upon others similar to bullying. For example, the manager observes that some children with autistic-type conditions, occasionally target those less mobile or passive, hitting them. Prior to their admission to the home, the children and young people are assessed, taking account of their vulnerability to bullying and whether their behaviour is likely to adversely impact on others. Staff use this and other information effectively to ensure that scope for bullying is controlled by accommodating at

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Protecting children from harm or neglect and helping them stay safe

any one time children and young people of similar age, interests and other harmonious characteristics. Staff provide a high level of supervision primarily to respond to needs arising from the children's disabilities and health problems, but which also ensures limited scope for unobserved bullying or similar behaviour. Although the children are not able to comment on this aspect of care, they all present as relaxed and content in the home's environment.

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Protecting children from harm or neglect and helping them stay safe

Staff continue to work effectively within the home's behaviour management policy, the focus of which is to promote the children's and young people's good conduct and helpfully modify any specific behavioural difficulties they present. The policy establishes strict safeguarding criteria to which any disciplinary measures must conform. This recognises that the children's and young people's disabilities may be a factor in any unacceptable behaviour they exhibit. Accordingly, each child or young person has an agreed behaviour management plan taking these factors into account and setting precise strategies within with staff must operate. Staff therefore focus on engaging the children and young people positively in a wide range of interesting activities rather than becoming preoccupied with disciplining. The children respond well to this approach in which staff continually praise, encourage and reinforce good behaviour.

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Protecting children from harm or neglect and helping them stay safe

Where it is necessary for staff to respond to the children's unacceptable behaviour, this is by way of diversionary and redirection strategies.

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Protecting children from harm or neglect and helping them stay safe

The registered persons ensure that there are wide-ranging and robust health and safety measures in place. Absence of any serious accidents or incident suggests these measures are successful in protecting the children from harm. Among the measures taken are risk assessment of all areas of the premises and activities involved in the care of the children and young people. Staff work within a range of health and safety guidelines and procedures for which they are provided initial and refresher training in areas such as fire safety, lifting and handling and food hygiene. This aspect of the children's and young people's care is rigorously monitored by the registered person and independent health and safety specialists. These measures are complemented by the very good security arrangements to protect the children from intruders. One weakness, however, is occasional lapses in conducting and recording fire alarm tests at the required

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Protecting children from harm or neglect and helping them stay safe

frequency. These are required to be carried out weekly, but were not done in some weeks preceding the inspection. It is imperative that these tests are carried out to provide certainty that the alarm system is maintained in good enough working order to detect and warn of any outbreak of fire.

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Protecting children from harm or neglect and helping them stay safe

Children and young people accommodated in the home are properly protected from adults who may be unsuitable to look after them. This is secured by the registered person's thorough approach to staff selection and other measures. All potential staff are vetted by means of references and criminal records check, and are not permitted to commence employment until the registered person is satisfied with the outcome of those checks. Similarly, visitors' access to the home is controlled and they are kept under supervision whilst on the premises. Combined, 6 of 8 Inspection Report: SC032069 all these arrangements are successful in keeping the children and young people safe from abuse and harm.

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Organisation

The organisation is good. Underpinning the very good quality of care that the children and young people are provided with, is the home's clear operational rationale as set out in its Statement of Purpose (SOP). This document complies with the relevant regulation. It sets out clearly the principles and methods, and the facilities and services that govern the running of the home and the care of the children and young people. The SOP is relevant to the needs of the children and young people, is current and accurately reflects how the home is being run. It has been summarised and presented in appropriate guides for children, young people and their parents. These guides provide helpful information about the general care experience which can be expected and what is expected of the children, young people and their parents.

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Organisation

An acting unregistered manager currently provides the leadership of the home under acceptable professional supervision arrangements made by the registered person. The management is competent in that it provides staff in sufficient numbers commensurate with the number of children and their needs. Staff are also efficiently deployed so that on each shift a named member of staff co-ordinates the care of each child to minimise the number of those involved in carrying out the child's intimate care. Additionally, management arrangements ensure that staff are allocated sufficient time to complete necessary administrative duties associated with the care of the children and young people. This includes, acceptable deputising arrangements for the absence of the manager. Managers also ensure that via formal handover at the end of shifts and regular staff meetings, communication is robust enough to facilitate the continuous

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Organisation

and consistently precise care of each child.

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Organisation

Almost all the care staff are relevantly qualified for their posts and they are provided with appropriate training to equip them to care for the children and young people safely and competently. This is supplemented by regular one to one supervision and annual appraisal, which are intended to ensure that they maintain the level of skill and performance necessary to meet the children's and young people's complex needs.

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Organisation

Established systems operated successfully, demonstrate that the manager and the registered person monitor the care of the children and the running of the home on a regular and rigorous basis. The outcome of recent monitoring highlights no worrying patterns in the way the children and young people are looked after nor any major issues concerning the running of the home. Where monitoring activity identifies areas where improvements are needed, the established management systems in place ensure they are addressed in reasonable time. This is 7 of 8 Inspection Report: SC032069 complemented by an embedded strategic planning process that facilitates staff in consolidating areas of high performance, such as short break care of poorly children. It also demonstrates managers, and staff commitment towards achieving continuous improvement in the overall quality of the children's and young people's care through the setting of a range of annual

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Organisation

objectives. For example, current objectives include greater efforts to enable the children's involvement in the planning and review of their care and strengthening of the working partnership with a local advocacy service to achieve this.

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Organisation

The home has good administrative systems including amassing necessary information in order to provide precise care inputs for each child or young person and for monitoring and reviewing their progress. All such information is efficiently organised into individual files which are structured to enable easy access to particular information.

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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): • ensure that all staff, including ancillary staff and agency staff, are provided training in recognising abuse, prevention of abuse and dealing with disclosures or suspicion of abuse (NMS 17.8) • ensure that the fire alarm system is tested weekly or otherwise at the frequency recommended by the local Fire Service. (26.8) 8 of 8 Inspection Report: SC032069

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