Children's Home run by Leicester City Council in Leicester

SC039038 Unique reference number 1 September 2009 Inspection date Warren Clarke Inspector Key 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 11 Inspection Report: SC039038

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Brief description of the service

This children's home provides residential care for children and young people, with learning difficulties, aged 12 to under 18 years. The home is purpose built and situated on the outskirts of a city. It is within easy reach of a range of community resources and public transport.

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Brief description of the service

There are seven single bedrooms with en-suite bathroom facilities, two of which also have a small kitchenette to support young people moving towards independent living. There are two lounges, a dining area and a games room. The home additionally has staff sleeping-in and waking-night facilities and office accommodation. Young people have access to a large rear garden.

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Brief description of the service

At the time of inspection seven young people, average age 17 years, were accommodated and were present. They all contributed to the inspection either directly or through observations of how they are being looked after.

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Summary

This key unannounced inspection assessed the home performance against all the National Minimum Standards (NMS) relevant to the national outcome framework for children in the areas: Being Healthy, Staying Safe, Enjoying and Achieving, Positive Contribution and Organisation. The home is providing the young people an exceptionally high standard of care and without any major weaknesses. Whist there are a few areas, such as the physical restraint records, requiring sharpening up of record keeping none of these impact on the actual quality of care. The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

At the last inspection a recommendation was made to address insufficient detail in the record of menus, as served. This has been satisfactorily addressed in that the menus now show what is served at all meals and in sufficient detail to demonstrate provision of a varied and suitable diet. However, there was a lapse in maintaining these records to the required standard during the absence of the Chef.

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Helping children to be healthy

The provision is outstanding. The entire catering arrangements are thoughtful. They recognise the importance of food in the young people's lives and use, most effectively, communal dining as an opportunity to foster inclusion and provide the young people an enjoyable social experience. For example, there is appropriate light hearted relating of the day's event at mealtimes and those in low mood seem lifted. The young people rate the quality of meals as excellent and, above all, place a high value on their good relationship with the Chef who takes account of their suggestions for the menus, ensures that they eat healthily and includes them in purchasing and some preparation of meals. All the care and catering staff work effectively and succeed in ensuring that the young people eat regularly, sufficiently and have a diet that is varied and wholesome. This includes young people who require a special diet for which they are exceptionally well provided. However,

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Helping children to be healthy

4 of 11 Inspection Report: SC039038 during a particular period no record was kept of the meals provided. It is necessary for this record to be maintained accurately because it is the means by which provision of a suitable and varied diet for the young people is demonstrated.

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Helping children to be healthy

Social workers responsible for the young people accommodated at the home rate the effectiveness of its health care arrangements highly. In some instances they cite significant improvement in the health and wellbeing of particular young people. This reflects the wide range of coherent measures such as the young people's access to primary health care services, regular dental, optical and medical health checks combined with active and productive promotion of healthy lifestyles which are well established. Staff work in effective partnership with health professionals to keep the young people well and maintain the very high standard of care for those with health problems. Of particular remark is that the young people have a good understanding of what staff do to keep them healthy. They are learning to take responsibility for maintaining their own good health and confident that they will be looked after well if they

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Helping children to be healthy

Staff are equipped with the necessary training to administer first aid and deal with the young people's minor illnesses. There are clear, rigorous procedures and provisions to ensure that young people's medicines are kept safe and administered correctly. Careful monitoring of this aspect of care contributes to the absence of error.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Resources provided and embedded practices recognise and respond acceptably to young people's need for privacy relevant to their age and development, but also their need to be kept safe. Each young person is provided an exclusive bed-sitting room with en suite facilities enabling them to conduct their ablutions in private. Subject to risk assessment, their bedrooms can be locked. This enables young people to keep their possessions safe and to withdraw from the rest of the group when they require privacy. Young people's privacy and safety is also effectively promoted by a range of safe caring practices such as staff waiting to be invited in before entering their bedrooms and clear guidelines about staff of the opposite sex assisting young people with their personal care. Staff's strict adherence to clear policies and guidelines ensures that young people's personal information is handled with utmost confidentiality.

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Protecting children from harm or neglect and helping them stay safe

Should young people have any concerns about how they are being looked after, the home's clear and acceptable complaints procedure enables them to present those concerns. The procedure is actively promoted to young people by staff, the visiting Children's Rights Officer and in a range of helpful documents including the Young People's Guide. Although they have not had cause to complain in recent times, most know how to do so and staff are committed to advocating for those without the capacity to register their dissatisfaction conventionally. For example, they observe behaviour closely in order to interpret the wishes and feelings of those with additional communication needs and generally try to resolve concerns at an early stage. The registered provider exercises rigorous scrutiny of the complaints system to ensure the young people have a voice and are listened to.

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Protecting children from harm or neglect and helping them stay safe

Currently young people experience no bullying within the home. Staff are effective and successful in fostering caring and kindness among the young people who enjoy good peer relationships and, in some, a high level of understanding and caring. The majority of the young 5 of 11 Inspection Report: SC039038 people understand the concept and nature of bullying as result of anti-bullying initiatives promoted by the Local Authority, schools and in the home.

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Protecting children from harm or neglect and helping them stay safe

Well-established and successfully tested arrangements are in place to respond to abuse or suspicion of it. The home's child protection procedures have been used effectively and are shown to be in accord with those of the Local Safeguarding Children Board. The mandatory safeguarding training that all staff undertake and additional training for care staff in the protection of children with special needs, equips them to both act to protect and respond appropriately to any suspicion or allegation of abuse. Young people feel safe in the home, comfortable with staff and have a good awareness of personal safety. The registered person also demonstrates the home's effective safeguard of young people in openly sharing with the appropriate authorities any serious concerns about their welfare. This provides the necessary scrutiny to ensure that the young people are properly protected.

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Protecting children from harm or neglect and helping them stay safe

Arrangements made for the event of a young person being missing or absent without permission, is allied to the sound multi-agency child protection system. Young people rarely absent themselves from the home, but where this has occurred, the local joint agencies protocol which takes full account of the young people's vulnerability, has been invoked successfully.

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Protecting children from harm or neglect and helping them stay safe

The staff work effectively to promote the young people's proper social and moral development. They do this within a system that takes account of each young person's circumstances, some of which may cause them to exhibit innocent but unacceptable behaviour. This is balanced against constructive individual strategies that encourage and reinforce the young people to behave well. This successful approach means that young people modify their conduct because they are enabled to realise that it is right, rather than in response to imposition of punitive measures. In this connection, some young people express confidence in staff's ability to treat them fairly and provide reassurance in the exercise of sufficient control when necessary. For example, where on occasions young people lose control and are at risk of harming themselves or others, staff use their training and skills in diffusion and safe physical intervention techniques

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Protecting children from harm or neglect and helping them stay safe

to great effect. All these measures have the effect of minimising the need for imposition of sanctions and use of physical restraints and are subject to rigorous arm's length scrutiny. However, pages have been removed from the physical restraint records. Whilst it clear that there is no impropriety, these records are required to be permanent and maintained in a form that guards against falsification. This is likely to be compromised if the practice of removing pages persists.

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Protecting children from harm or neglect and helping them stay safe

An effective range of health and safety measures informed by risk assessments are demonstrated to safeguard the young people and staff from harm. Staff demonstrate that the system that underpins this is sufficiently robust to identify potential hazards and ensure that where they exist, action is taken to remove or control them. This is demonstrated in areas such as fire safety, protection of the young people from access to substances harmful to health and through control of the hot water temperature, the risk of scalding. Staff are careful in ensuring measures to protect the young people from harm are reasonably balanced against them having opportunities to live full and active lives.

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Protecting children from harm or neglect and helping them stay safe

A range of robust measures are established to protect the young people from potential abusers. All staff are thoroughly vetted to ascertain their suitability to look after children and young people. This includes taking up references and completing criminal record and other barring checks. Those Young people commenting on this aspect of their care say the staff are 'fantastic'. 6 of 11 Inspection Report: SC039038 They cite the very good security arrangements that protect them from intruders as being among the things that cause them to feel safe in the home.

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Helping children achieve well and enjoy what they do

The provision is outstanding. The young people believe they are provided excellent support to meet all their needs. In particular, the young people are supported and guided towards establishing a positive self-identity as reflected in their differing style of dress and interests. Assessment and care planning processes properly recognise the young people's continuing development and a coherent range of services is provided to equip them to understand and successfully adjust to the inevitable physical and emotional changes of adolescence. For example, staff work effectively with the specialist nurses to provide young people individual support in matters such as their health, disability, sex and relationships.

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Helping children achieve well and enjoy what they do

Daily routines such as communal dining and the extensive range of group and individual leisure activities in which the young people are engaged, ensure that they are involved and experience a sense of inclusion both within the home and the wider community. Consequently. The vast majority of young people have a network of peer friendships and express feelings of contentment in the home and a sense of belonging. All of this is set in the context of needs arising from the young people's diverse racial, religious and cultural background, and means of communication. The fulfilment of these needs is demonstrated to very high degree and in particular instances staff's thoughtfulness, imaginative approach and sensitivity to the needs of the young people and their families are outstanding.

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Helping children achieve well and enjoy what they do

Staff operate within a clearly thought out set of principles for supporting the young people's education. In essence, staff act as the good parents with ambition for the young people to succeed. Accordingly, the home provides young people a stimulating environment where learning both formal and informal is encouraged and facilitated. For example, there is a wide selection of books, games and newspapers available and some young people have their own computer. Young people benefit from hobbies and leisure interests primarily for enjoyment but some of which contribute to their formal education and promote personal development such as the confidence and poise which some present. The overall impact of these measures is that all the young people are in full-time education. They exhibit enthusiasm for learning and although some find some aspects of school work challenging, they nevertheless relish their total school

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Helping children achieve well and enjoy what they do

experience and have an almost exemplary attendance record.

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Helping children make a positive contribution

The provision is outstanding. Young people enjoy excellent all round care and this is underpinned by a most effective system of assessment and care planning. The staff ensure that they amass all the information necessary to understand each young person's circumstances and needs, including those arising from their sex, disabilities and, where relevant, their race, religion, culture and communication difficulties. There are established systems in place to ensure continuous assessment in order that staff can respond appropriately to the young people's changing needs. This yields a great deal of success. Where staff have altered their approach to particular behavioural difficulties presented, this results in near eradication of some of those problems. 7 of 11 Inspection Report: SC039038 Young people who offer a view believe that since joining the home, they have made great positive strides in all areas of their development. The staff and the young people's social workers

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Helping children make a positive contribution

cite a number of factors to support this. In order to achieve this, successful planning goes into ensuring that clear objectives are set into a plan of action detailing how each young person is to be looked after day-to-day. Staff and young people therefore work together with a clear sense of purpose which ensures that no aspect of care is left to chance.

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Helping children make a positive contribution

An effective part of the coherent and systematic approach to the care of the young people is shown in the robust ongoing monitoring and review of their progress. Staff maintain careful records of care inputs and each young person's progress. Accordingly, where there are difficulties or barriers to progress these are identified quickly and the placement plan altered in order to overcome any problems. This is exemplified particularly in the care of young people with complex needs. A remarkable feature of staff's approach is their commitment to keeping the young people informed of developments in their care and including them in the regular review and decision-making processes. The young people who commented on this aspect of care are content with how it is organised and staff observe that some now have the capacity to make confident contributions.

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Helping children make a positive contribution

The home operates within a clear system to support young people joining and leaving its community in ways that minimise any anxieties they may have and create the circumstances for success in both events. The process for determining whether the home is suitable for young people referred for admission is well-established and effective. In all instances young people join and leave the home on a planned basis and in line with a programme that enables them to understand and be comfortable with the changes involved. Of particular note is the arrangement in some instances whereby staff with whom a young person has strong attachment remain involved until the young person becomes settled in the new environment.

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Helping children make a positive contribution

Emphasis placed on constructive maintenance of contact with their families sees the home contributing to the current situation in which all the young people have contact with at least one family member. The home provides excellent facilities for family contact and makes some exceptional arrangements so that such contact fulfils needs arising from the young people's race, religion and culture. In trying to avoid all the young people inviting their friends to the home at the same time, which would have staffing implications, the explanation given to young people has caused some misunderstanding. Some young people are left with the understanding that they are not allowed to invite friends to the home. The manager expresses keenness to clarify the position for the young people.

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Helping children make a positive contribution

Staff adopt the principle that one of the main skills that they need to teach the young people is how to make informed choices. This, of necessity, requires the young people to understand their circumstances and be involved in the planning of their care and review of their progress. Staff therefore demonstrate that most of the young people now have the capacity to influence decisions about their present and future care. Young people are relaxed in the home and exhibit confidence which suggests that they are listened to. For example, they opt to pursue different interests and arrange and adorn their own bedrooms to reflect their own personality. They are knowledgeable about the home's routine, staff roles and responsibilities, and who is on duty at particular times.

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Achieving economic wellbeing

The provision is good. 8 of 11 Inspection Report: SC039038 The assessment and care planning process contributes successfully to the preparation of young people for adulthood. The assessments provide a clear understanding of young people's strengths and difficulties. Staff use this information productively to consolidate the strengths and take action to overcome the difficulties. For example, some young people need, and are provided additional support with practical living skills hence there is focus on areas such as preparing food and self-care skills. Staff have a good working knowledge of local resources for young adults with special needs. They demonstrate success in working in partnership with adult services to achieve seamless transition of young people from the home to those services. Some young people whilst understandably anxious about leaving the home for more adult or independent way of living, are reassured by their own preparation and how well staff have

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Achieving economic wellbeing

handled this when others have graduated from the home.

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Achieving economic wellbeing

The young people are living in a safe and homely environment, which is equipped to meet their needs. Each young person benefits from facilities that provide them with a very good material standard of living. Other facilities such as the training flats are ideal in enabling young people to practise the independent living skills that they are being taught. Communal areas comprising spacious sitting, dining and games rooms provide opportunities for different activities to take place simultaneously. The arrangement in the main kitchen, which is equipped on a domestic scale, enables young people to observe the preparation of food in safety and to be able to use this facility under supervision. Laundry facilities are also more than adequate for the number of young people accommodated. Young people benefit from a pleasing outlook from all areas of the home enhanced by the well-maintained gardens, which are equipped to provide a useful

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Organisation

The organisation is outstanding. Managers and staff have established, for the running of the home and care of the young people, a clear set of working principles bounded in high aspirations and successfully translated into practice. This is set out in the home's operational policy or statement of purpose (SOP). The document is up to date and accurately outlines the methods used in the care of the young people and the facilities and services to support this. Young people are enabled to gain a good understanding of how the home operates, what is expected of them and what they may expect in the way they are looked after. This is facilitated by the children's guide, which summarises the SOP and presents it in a format appropriate to the young people's age and understanding.

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Organisation

The promotion of equality and diversity is outstanding. It is reflected in all aspects of the principles and practices that that underlie the running of the home and exceptionally so in the care of the young people.

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Organisation

Staffing levels are very good and staff are effectively deployed. Excellent management and leadership that steer the home, achieve a stable care staff team, members of which are trained and qualified to provide the level of competence required to respond to young people's special needs. All members of the home's management team have the relevant experience necessary for their posts and lead less experienced staff in meeting the needs of the young people competently. Other care staff members collectively hold qualifications that exceed the ratio laid down in the NMS.

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Organisation

Sound arrangements are in place for continuity of management and leadership to maintain the high standard of care achieved in the registered manager's absence. Adaptability and the 9 of 11 Inspection Report: SC039038 sometimes flexible approach required to meet the young people's needs is being achieved by a skilled staff team and effective communication, an aspect of which includes handover sessions at the end and beginning of shifts and regular staff meetings. The young people believe they are always looked after very well by all staff and, because of this, particular young people have some anxiety about the time when they will leave the home.

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Organisation

The registered person continues to provide the support, training and development that staff need to sustain their performance in looking after the young people to the excellent standard achieved. This is reflected in the home's sound staff induction and foundation and ongoing in-service training programmes including sponsorship for some staff to undertake professional social work training. All care staff have regular one-to-one supervision and combined, these measures cause them to approach the care of the young people with confidence, purpose and professionally. Staff experience of the support they receive and the care of the young people is characterised by the comments: 'There is good support to the staff from the manager'. The home is without doubt the best … I have worked in. Staff really show genuine care towards the young people and have a valid interest in their future'.

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Organisation

A comprehensive system of monitoring the operation of the home is well-established and is effective in promoting and safeguarding the welfare of the young people. This ensures that the home is run in accordance with its SOP. Monitoring in this area is rigorous and critical. For example, procedural details in the recording of young people's meetings and physical restraint have been highlighted in recent scrutiny reports and the matters have been addressed. In addition to this, the registered person's commitment to assuring ongoing improvement in the quality of the young people's care is shown in the current development plan which sets objectives to consolidate the home's strengths and prevent deficits.

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Organisation

Young people are being provided care that responds precisely to their individual needs. This is apparent from their records which are maintained on an individual basis and contain all the information necessary to inform planning and monitoring of their care. The records are securely stored and are organised such as to facilitate young people's easy access should they opt to see them.

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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 the record of menus, as served, is consistently maintained so as to demonstrates provision of a suitable and varied diet (NMS 10.4) • ensure that the record book in which any use of physical restraint is entered is bound, sequentially numbered and maintained in permanent form (NMS 22.9) 10 of 11 Inspection Report: SC039038 • ensure that there is written guidance for staff, and made known to the young people, about arrangements for young people to be visited at the home by their friends and when and how friends can take part in activities in the home (NMS 4.). 11 of 11 Inspection Report: SC039038

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