Children's Home run by Leicester City Council in Leicester

SC039056 Unique reference number 25 September 2009 Inspection date Warren Clarke Inspector Key Type of Inspection

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27 February 2009 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 10 Inspection Report: SC039056

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Brief description of the service

This children's home is operated by a local authority and is situated in a residential area in the north east of the city. It is registered to provide short break or respite care for up to nine children and young people from the age of eight years to under 18 years. The children are mainly accommodated in one of two units. One unit accommodates children with learning difficulties who also have wide ranging physical disabilities and in some cases, complex health needs. The other unit provides accommodation to children who often exhibit challenging behaviours allied to their learning difficulties. Each episode of respite care is generally planned in advance, however, the service also aims to respond to emergency family situations where this is in the child's best interests. Two young people, exceptionally, are being accommodated in the home on a full time basis.

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Brief description of the service

The building is specially designed for its purpose and is mostly at ground level. It is divided into separate areas, one being exclusively for administrative use and accommodating facilities and services accessible to the children in residence, but not exclusively. Both of the residential units are self-contained and offer single bedroom accommodation, dining, bathroom and toilet facilities. A two-storey section of the building has been equipped as a training flat for young people who are being prepared towards living more independently.

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Brief description of the service

There were six children and young people present during the inspection all of whom were seen and all of whom contributed to the process to a greater or lesser extent.

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Summary

This unannounced key inspection assessed the home's performance against the national minimum standards (NMS) as relevant to the Every Child Matters outcome groups: being healthy, staying safe, enjoying and achieving, positive contribution, economic wellbeing and organisation. The home consistently provides care of an exceptionally high standard and outcomes achieved for some children and young people are extraordinarily successful.

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Summary

Areas for improvement are confined to some minor finishing from the recent refurbishment and unsound window frames in one area of the home. 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 ensure that all areas of the home are decorated and furnished to a standard which creates a pleasant domestic environment, appropriate to the number, gender mix, disability, age, culture and ethnic background of the children being accommodated. The home has undergone substantial refurbishment, which addressed all the deficits that elicited the recommendation. All areas of the home are now pleasingly decorated and furnished to a standard that creates a comfortable and homely environment.

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Helping children to be healthy

The provision is outstanding. 4 of 10 Inspection Report: SC039056 An exceptionally high standard of facilities and services is provided to respond to the children's and young people's health needs. Mealtimes are carefully arranged to ensure that the children and young people dine communally, in comfort and to ensure that these events are enjoyable. The children and young people who offer comments consider the quality and variety of food to be very good. Catering and care staff diligently identify where special diets for medical or religious reasons are required and work effectively to ensure these are provided to the satisfaction of children and parents. All the children and young people are provided regular, wholesome meals nearly all of which are prepared on the premises using basic ingredients and, importantly, the children and young people are consulted and contribute to the menus. In some instances imaginative approaches are employed to facilitate the involvement of those with

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Helping children to be healthy

communication difficulties in this process. Of particular note, is the efforts that staff make to ensure that children and young people who are fed unconventionally are also included in the communal dining experience.

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Helping children to be healthy

The home provides a first rate standard of service which enables children and young people, in some instances, with complex disabilities and health problems, to experience group living outside their families. They thereby also benefit from the associated social and personal development opportunities that this permits. This is made possible by the excellent health care arrangements that the home makes, which includes providing appropriately trained and competent staff and a wide range of adaptations, aids and equipment. For example, the hoists and other equipment enable staff to assist the young people with aspects of personal or intimate care safely and in ways that promote privacy and preserve dignity. An individual health plan, a discrete aspect of the overall care or placement plan, sets out for each child or young person their health needs and precisely how the day-to-day care inputs are to meet them. In all cases

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Helping children to be healthy

examined health care inputs are of a high standard and reveal effective work by staff in partnership with health professionals culminating in the children receiving the care that they need.

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Helping children to be healthy

The registered persons ensure that they have the necessary written consent to provide or arrange any treatment that a child or young person might need. This includes administering both prescribed and non-prescribed medicines and first aid. All care staff have completed first aid, safe handling of medication and other relevant training that equips them routinely, to care for disabled children with the safety and competence that they consistently display. There are sound medication policy and procedures in place which ensure that all medicines are safely stored, administered and documented. Combined with rigorous monitoring, efficient communication among, staff, parents and schools, these measures are successful in avoiding errors and shown to be fit for purpose in instances where children are on complex medication regimens.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. The manager and staff take full account of the children's and young people's disabilities, and in some instances their high level of dependence, when organising resources and shaping care practices. The home is therefore efficiently arranged and equipped to promote each child's or young person's privacy and preserve their dignity in all aspects of their care. For example, each child or young person has an exclusive bedroom suitably fitted with aids and equipment so that any assistance that they need with their intimate care, is given in private. Staff guide and support the children and young people to be as independent as possible in aspects of their 5 of 10 Inspection Report: SC039056 own care such as dressing, bathing and toileting as a means of promoting their privacy. These practical arrangements are complemented by policies, procedure and practices which are strictly

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Protecting children from harm or neglect and helping them stay safe

applied to ensure the children's and young people's personal details are handled confidentially.

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Protecting children from harm or neglect and helping them stay safe

Should children, young people, or others on their behalf, have cause to express dissatisfaction about the quality of care or the home's services, they are provided with the means to do so. The home adopts the local authority's comments, compliments and complaints quality assurance system that enables service users to make comments or suggestions for improvements, compliment outstanding service and complain when service quality is lacking. The discrete complaints procedure is actively promoted to the children and young people in a format appropriate to their age and understanding. Staff recognise that communication difficulties may limit some children's ability to convey their concerns conventionally. In such instances, staff attuned to a child's means of communication interpret his or her concerns and are committed to advocating on their behalf. Where complaints are made such as two made by a young person since the last inspection, they are taken seriously, considered fairly and resolved

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Protecting children from harm or neglect and helping them stay safe

All staff employed in the home are provided relevant training to equip them to understand the nature of abuse, act to prevent it and to respond to any allegations or suspicion of it appropriately. This together with the home's effective safeguarding policy and procedures, which are consistent with those of the Local Safeguarding Children Board, forms a robust and successful safeguarding strategy.

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Protecting children from harm or neglect and helping them stay safe

The home adopts the local authority anti-bullying bullying policy and staff build on work done at school with the children and young people to understand the nature of bullying. This takes account of their age and level of understanding. Whilst there is no calculated and malicious bullying among the children and young people, staff are still mindful that the behaviour of some children may impact on others in ways similar to bullying. In all cases, therefore, risk assessment is used to identify those whose challenging behaviour may have an adverse impact, and excellent measures are adopted where this might pose any threat to the comfort and well-being of others. For example, there is always a high level of supervision, careful selection to ensure compatibility of those resident at any one time and separation of the most fragile and vulnerable from those who are more robust and unpredictable. Work done in this area

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Protecting children from harm or neglect and helping them stay safe

exemplifies how the manager and staff bring together coherently the home's various policies. In this instance they demonstrate unification of the countering bullying policy with the equality and diversity policy, which means that insulting racist name calling would elicit a similar response within the guidance of both policies.

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Protecting children from harm or neglect and helping them stay safe

Clear procedures and established local agencies protocol are in place to respond to any event of children or young people being missing or absent from the home without permission. The procedures and protocol properly recognise the children's and young people's vulnerability and the urgency which would be necessary to recover them should they be missing. No child or young person has been so absent. Staff are sufficiently aware that whilst the children and young people look forward to spending time at the home and are unlikely to run away, some may seek to wander off the premises or away from the group on occasions such as outings. In order to combat this, there is a high level of supervision and effective perimeter security.

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Protecting children from harm or neglect and helping them stay safe

Staff are provided clear guidance to assist the children and young people to manage their behaviour and to enable reasonable control and discipline to be maintained. This includes the 6 of 10 Inspection Report: SC039056 clear parameters within which staff must operate, ensuring their disciplining is proportionate and takes account of the children's and young people's age and level of understanding. Staff therefore work effectively in encouraging and reinforcing the children and young people to behave acceptably, and whilst firm in their response to poor conduct, they are nevertheless sparing in the use of sanctions. Physical intervention or restraint is used only where children or young people are causing harm to themselves or others. It continues to be the case that staff's effectiveness in helping the children and young people to shape their behaviour positively, enables greater focus on positive pursuits and building up of good relationships rather than

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Protecting children from harm or neglect and helping them stay safe

disproportionately in control and discipline.

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Protecting children from harm or neglect and helping them stay safe

The home provides a safe environment for the children and young people who are successfully protected from harm by a wide range of well-established health and safety measures. There is compliance with necessary assessments and risk management in all areas such as fire precaution, use of aids and equipment and other activities involved in the care of particularly vulnerable children and young people.

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Protecting children from harm or neglect and helping them stay safe

Robust systems are well-established to ensure that staff selected to work in the home, or on the premises, are suitable people to look after or have substantial contact with children and young people. The registered person operates a robust staff selection and vetting process which includes assessment of competence and carrying out of checks such as criminal records disclosure of all those who are employed. This process is overseen by the registered manager, but is also scrutinised by one of the registered provider's senior managers to ensure it is as fool-proof as possible. Similarly, robust security measures are instituted to protect the children and young people from intruders and the system employed to ensure the control and supervision of visitors is effective.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Children and young people accommodated in the home are provided exemplary care that addresses needs arising from their disabilities and other personal characteristics such as their sex, race, culture and religion. Specialising, most successfully, in the care of children with disabilities, the home has coherent methods for promoting the personal development of the children and young people so that they experience positive social and personal relationships and live fulfilled lives. For example, staff skilfully manipulate the home's environment and group living in areas such as communal dining and group leisure activities to ensure the inclusion of all the children and young people. Commensurate with their age and level of understanding, staff provide the children and young people sound guidance in social skills and facilitate their inclusion in the wider community. Staff are also adept in helping young people to understand

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Helping children achieve well and enjoy what they do

physical changes, personal health matters and appropriate behavioural adaptations required to accommodate their development towards adulthood. Apart from parents and staff, the young people have access to a wide range of legitimate adults to whom to turn with any personal problems they may have.

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Helping children achieve well and enjoy what they do

The home operates within an accomplished policy to support the children's and young people's education. This yields a stimulating environment in which the children and young people are thriving. All the children and young people have permanent and full-time education arrangements and achieve regular school or college attendance. Although parents retain overall responsibility for the education of those accommodated on a respite basis, staff are effective 7 of 10 Inspection Report: SC039056 in ensuring there is no disruption to those children's existing education arrangements and that the home provides the stimulation to enhance their learning. Amongst others, these efforts have returned outcomes for children and young people such as graduation to higher education, stability and achievement of social and behavioural foundations from which formal learning is being built.

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Helping children make a positive contribution

The provision is outstanding. Children and young people accommodated in the home are benefiting from care of a consistently high standard which is underpinned by an outstanding assessment and care management system. Within the system, each child's or young person's needs are clearly identified, definite outcomes are determined informed by the Every Child Matters outcome framework and a precise plan of routine care is established. Demonstrable success in areas such as the children's and young people's health, education and personal development illustrate the clarity of purpose and effectiveness with which staff are enabled to provide their care. It also productively facilitates the full inclusion of the children and young people and takes account of their aspirations.

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Helping children make a positive contribution

A successfully proven management system is established for monitoring and review of the children's and young people's progress. Records are kept of daily care inputs and of the children's individual responses. Monitoring mechanisms such as progress discussions at staff meetings, end of stay reports and official review of placement plans, ensure that any difficulties or lack of progress are quickly identified and addressed. Accordingly no aspect of the children's and young people's care is left to chance.

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Helping children make a positive contribution

The home demonstrates that it works in effective partnership with parents and makes flexible arrangements for contact between children and their families. Such contact arrangements are firmly established in the care planning for each child. Children and young people who are permanently accommodated, are currently enjoying constructive contact with their families and others who are important to them.

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Helping children make a positive contribution

There remains a long established and accomplished process for introducing children and young people to the home, and for planning their leaving. Children and young people joining the home for the first time are handled with great care and sensitivity to overcome any anxiety this may provoke for them or their parents. There is an efficient system for receiving referrals, assessing whether the home can meet a child's needs and for introducing the child in a planned and gradual way. A similar process is employed to prepare children or young persons for leaving the home. This process takes full account of the attachments that they will have made. In some instances assigned staff remain involved with the child's or young person's care until they are settled in the setting to which they have been transferred.

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Helping children make a positive contribution

Staff are provided clear guidance in building children's and young people's capacity, particularly those with communication difficulties, to participate and to be consulted about decisions about their future, their day-to- day care and how the home is run. Young people who are permanently accommodated in the home express complete satisfaction with their inclusion in these matters. Generally, the children and young people consider that staff are approachable and that their views are heard and taken seriously. Where children or young people with substantial communication difficulties are new to the home and staff are not fully conversant with their mode of making their views and feelings known, great care is taken to find out from their 8 of 10 Inspection Report: SC039056 parents the particular child's likes and dislikes and the precise ways in which they prefer to be supported in their personal care.

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Achieving economic wellbeing

The provision is outstanding. It remains the case that the majority of children are accommodated in the home on a sessional basis and therefore, their overall preparation for adulthood remains the responsibility of their parents. The home does, nevertheless, contribute substantially and most productively by providing the children and young people the opportunity to live away from home in a setting where they are successfully taught and are able to practise social relationships. In this regard, staff exploit fruitfully, opportunities presented by the give and take nature of group living. The home's general care regime is structured to encourage independence relative to the child's or young person's age and level of functioning. For example, self-care skills such as dressing and washing are taught and reinforced. Importantly, staff demonstrate in their care of particular young people, that they have the knowledge and skills and access to appropriate resources to

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Achieving economic wellbeing

equip young people with disabilities to live profitable independent lives and to approach adulthood with confidence.

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Achieving economic wellbeing

The children and young people enjoy a comfortable and safe living environment in the home. The building is maintained in sound structural condition, has been refurbished and extended to enhance its facilities and is furnished and equipped to an exceptionally high standard. The units in which the children are cared for are both homely and equipped, arranged and adorned to create a most pleasing environment appropriate to the children's and young people's needs. However, there is some minor completion work outstanding from the refurbishment and some widow frames in one area are showing signs of rot.

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Organisation

The organisation is outstanding. The home is successfully operated to enable children and young people to thrive in its environment. This is driven by competent management and leadership as reflected in the sound rationale set out in the current statement of purpose (SOP). This document, a blueprint for the high standard with which the registered person expects the home to be run, not only complies with the relevant regulation, but accurately details principles and methods on which the home is run. Information from the SOP is helpfully summarised and presented in appropriate format in a guide for the children, young people and parents. The guide provides information about the standard of care and services children and young people can reasonably expect and what to do if they are dissatisfied.

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Organisation

Sufficient numbers of suitably qualified and experienced staff are employed and efficiently deployed to respond effectively to the children's and young people's needs. Management and leadership arrangements succeed in establishing accountability and in ensuring that continuity and consistency of approach to care of the children and young people are not compromised. The home performs exceptionally well in retaining staff. This benefits the children and young people, particularly those most dependent who rely on staff to assist with their personal care, in that they don't have to regularly adjust to new people. Staff consider that they are well supported and provided the time and resources to perform their duties to a high standard. 9 of 10 Inspection Report: SC039056 In securing a highly trained and skilled staff team, those in charge of the home demonstrate commitment to staff development. There is an established induction and foundation programme

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Organisation

for new staff together with ongoing in-service training and development for experienced staff. This enables staff to continuously update their knowledge and hone their skills to achieve the competence they exhibit in, for example, the care of children with complex health and other needs. Young people who comment in this regard, say that they think the staff are very good and that is why they so enjoy living at the home.

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Organisation

The welfare of children and young people continues to be safeguarded and promoted by a rigorous system of monitoring and review to sustain high standards of care and efficient running of the home. Recent monitoring and review conducted on behalf of the registered provider reports favourably, but also shows that the task is approached critically. Where shortfalls are found, they are highlighted and addressed speedily. For example, where it was noted that on some occasions staff failed to complete the handover record in the manner required, this was quickly remedied. These scrutiny documents are made available to staff as are Ofsted inspection reports. The current development plan sets objectives for improvement of the facilities and services that the home provides for children and families. Substantial upgrading and extension of the home's range of services and facilities demonstrate sound strategic planning and firm

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Organisation

commitment to ongoing improvements in the quality of service.

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Organisation

The promotion of equality and diversity is outstanding. This is supported by the home's clear policies and practices reflected in all aspects of the care of the children and young people and the running of the home. For example, the children provided respite care are from diverse race, religion and sex. All the personal characteristics and needs arising from them are taken into account and obviously reflected in the children's and young people's excellent quality of care.

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Organisation

High standards of record keeping are maintained reflected in the efficient organisation of the children's and young people's records which are kept on an strictly individual basis and include all the information necessary to plan their care and monitor their progress. The procedure for children's and young people's access to their personal records is promoted in the SOP, and should they seek to do this the information is arranged in a way that would make this straightforward.

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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 necessary repair work is carried out in order to maintain the interior and exterior of the home are maintained in good state of structural and decorative repair (NMS 24.3). 10 of 10 Inspection Report: SC039056

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