Children's Home run by Nottingham City Council in Nottingham

SC034900 Unique reference number 21 January 2010 Inspection date Dawn Taylor 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 9 Inspection Report: SC034900

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Brief description of the service

This service provides residential short stay care to young people with learning and physical disabilities aged 8 to 19 years old.

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Brief description of the service

The home is close to the city centre which is fully accessible to the young people. The home has two units, one for young people with learning disabilities and the other for young people with physical disabilities or able-bodied young people who require a quieter environment.

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Summary

This was an announced full inspection in which all key standards were assessed. This is a good service with some outstanding features. Being healthy, staying safe, economic well-being and organisation are all rated as good. Enjoying and achieving and positive contribution are both rated as outstanding. Young people receive regular planned breaks that enable families and carers to continue to care for their children at home. The quality of care and support is assessed as good. Staff demonstrate a caring attitude and strong commitment to their work. The leadership and management of the home is effective and clearly has the ability to gain trust from families and carers. The home continues to place high value on establishing the wishes, views and feelings of all the young people who use the service, whatever their communication method. The management of the home continues to ensure that each area of care to individuals

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Summary

is well monitored. This ensures that a consistent excellent quality of care is delivered. Awareness of equality and diversity issues and practice is well established. 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

At the last inspection the registered person was required to ensure that the home maintained a complete record of physical interventions used and fire checks undertaken. These requirements have been met. Risk assessments have been carried out in relation to the premises, aids and activities and the complaints procedure has been updated to include Ofsted's details. Staff files have also been updated to ensure they contain all information required by the Children's Homes Regulations.

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Helping children to be healthy

The provision is good. Healthy living and good health care continue to be strongly promoted at this service by a well-informed staff team. This results in young people's physical, emotional and social development needs being effectively met.

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Helping children to be healthy

Staff recognise their responsibility to meet primary health care needs for young people while they stay for short stay visits. Parents and carers retain full responsibility for meeting their child's health care needs. All young people remain registered with their own family practitioners and dentists.

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Helping children to be healthy

Each young person's physical, emotional and health needs are assessed prior to receiving short stay care at the home. This is recorded in a residential action plan and carefully monitored. 4 of 9 Inspection Report: SC034900 Records include details of health status and which General Practitioner they are registered with. Staff receive training specific to individual's health care, for example epilepsy, Angelman Syndrome and teeth brushing techniques.

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Helping children to be healthy

Some staff have first aid training and are able to treat minor injuries and illnesses. All accidents and illnesses are logged and the record is regularly monitored by senior staff. The administration of medication is organised, efficient and safe. A clear protocol on administering prescribed and non-prescribed medication is available for staff. Registered nurses (employed as care staff) have responsibility for the safe storage and management of medication although other competent assessed staff may also be involved in this. Written records provide clear details of administered medication and these are checked by senior staff on a daily basis.

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Helping children to be healthy

Individual's dietary needs and preferences are explored and very well provided for. They differ tremendously and are met by staff who are highly skilled and knowledgeable. For example, staff are trained in Percutaneous endoscopic gastrostomy (PEG) feeding for specific individuals. Dietary considerations are also given for young people from different cultures and religions. Young people are encouraged to cook or bake as part of their independence skills.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. This service continues to provide a consistently safe and secure environment for young people receiving short breaks. The staff team build strong relationships with young people and work effectively in partnership with parents and carers.

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Protecting children from harm or neglect and helping them stay safe

Staff are able to manage privacy and confidentiality well. Staff convey respect that preserves young people's rights to dignity and personal autonomy. Staff are sensitive to how they support and provide intimate and personal care to young people. For example, they inform them what is happening or about to happen. Residential action plans give good emphasis about the kind of support which is needed and its frequency. Staff also receive training that examines practice issues, attitudes and disability awareness.

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Protecting children from harm or neglect and helping them stay safe

There is established working practice that promotes a safe environment where bullying is not tolerated, positive behaviour is promoted, concerns are listened to and the safety of the child is paramount at all times. The setting has a clear policy on complaints which is accessible and well publicised. It is simple to understand and use. There are suitable arrangements in place to allow young people with disabilities to complain as well as their families and carers. Complaints are clearly recorded and include the nature of the complaint, the actions taken and the outcome. These records are regularly monitored independently from the staff at the home.

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Protecting children from harm or neglect and helping them stay safe

There are clear procedures for responding to safeguarding concerns in the home. Staff are knowledgeable about what they need to do to protect individuals, and about what they should do, should there be a concern or safeguarding issue. There are procedures for the vetting of staff and visitors to the home including criminal records bureau checks at enhanced level, and references, all of which are in place prior to staff appointment. The safeguarding policy and anti-bullying policy have been recently reviewed and amended. The anti-bullying procedure has been updated to include a definition of and actions to be taken with regard to cyber-bullying. All staff are booked into a safeguarding training session in March; this will include ancillary staff. 5 of 9 Inspection Report: SC034900 Bullying behaviour is taken seriously and discussed between staff and young people on a regular basis. Practical arrangements with regards to short breaks for young people who do not get

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Protecting children from harm or neglect and helping them stay safe

on with each other are considered as part of the matching process. Staff are mindful of the vulnerability of young people with disabilities who require assistance to move when with physically able children. Risk assessments provide a comprehensive overview of the risk of young people either being the victim of bullying or a young person with a behaviour that could affect others.

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Protecting children from harm or neglect and helping them stay safe

Due to the nature of the young people staying at this home, any young person who is absent without the staff being aware, is of significant concern. Staff are clear about the process in notifying parents and other agencies in such circumstances.

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Protecting children from harm or neglect and helping them stay safe

The staff have built up very positive relationships with the young people and see them in an extremely positive light. Their needs and behaviour are well understood by the staff and there is an emphasis on behaviour as a means of communication. The staff's approach to behaviour is extremely positive, both in their language and methods. They have completed training and are competent in diffusing situations to try to avoid the use of physical intervention. Staff try to find the root of the problem and understand how in turn, these issues impact on the young people emotionally and on their behaviour.

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Protecting children from harm or neglect and helping them stay safe

The short breaks service continues to adhere to Nottingham City Council's health and safety procedures. Staff are trained in safe moving and handling. Overhead hoists, electric beds and access to a manual hoist allow staff to adhere to safe moving and handling practices. There is a maintenance and inspection process for gas, electricity and water installations. Electrical testing is carried out annually and a record is kept. The maintenance of equipment, electric beds and hoisting equipment is also carried out annually. All fire safety checks and drills are carried out at appropriate intervals.

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Helping children achieve well and enjoy what they do

The provision is outstanding. A key strength of this service is its commitment to working in partnership with each young person, their parents or main carers, education and health professionals and any other agencies that may need to be involved, to ensure that all work is child focused, consistent and well informed. This service successfully meets its objective to 'provide a safe, but stimulating environment where individuals are valued and encouraged to advocate for themselves. Carers and young people have choices and rights, which, as providers of a service, we will identify and support.'

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Helping children achieve well and enjoy what they do

Staff consistently make themselves accessible and available to young people, which means that they are responsive and attentive to individual's needs. Key working arrangements are strong and the home's records evidence lots of one-to-one discussions between staff and young people about important areas of need. The Registered Manager regularly assesses how well the home is supporting each young person in meeting the requirements outlined in residential action plans. Assessments are comprehensive and clear, and focus on how young people can benefit from the type of support required.

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Helping children achieve well and enjoy what they do

All young people receive education in the community and those young people who are using the short break service continue their usual school placement during their stay. Transport is well organised so that this can be facilitated. Communication between the schools and the 6 of 9 Inspection Report: SC034900 home is well established. Information sharing in relation to young people's behaviour, health and other issues are recorded in a communication book which the parents and school complete on a daily basis. This provides staff with current and relevant information on each young person's situation prior to and while staying at the home.

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Helping children make a positive contribution

The provision is outstanding. Residential action plans are completed and regularly reviewed to ensure that they are current and reflect the needs of young people requiring short breaks. Key workers review these plans in consultation with parents and carers to ensure any changes with the plan of care are reflected in the plans. Young people's self-esteem is promoted with positive strategies in place to develop their personal and social development. Staff demonstrate a positive attitude to providing good quality care and support.

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Helping children make a positive contribution

Care reviews are well planned and organised to ensure that all parties are represented during the meeting. Young people are always encouraged and enabled to participate in activities, make decisions about their lives and influence the way the service operates. The staff are continuing to develop forums and communication tools that promote young people's independence, social skills and community involvement. A young person's right to communicate and express a view is key to the service's values and ethos and runs throughout their policies, procedures, staff guidance and information for parents. Young people are consulted about every aspect of their care as well as activities and social events. They are also enabled to raise issues through staff or the home's manager. The opinions and views of young people and their families and carers are proactively taken into account when decisions affecting welfare and the

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Helping children make a positive contribution

Young people are supported to remain in contact with their families throughout their stays. Each young person's contact arrangements are different and recorded in their care plan. All contact is well recorded.

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Helping children make a positive contribution

Young people are supported when they move into the home and staff make them feel very welcome and try to settle them in, in a supportive way. The admission is managed at a pace that is suited to the individual, for example, tea visits with parents, culminating with the young person visiting for a short period without parents. The build up to an overnight stay is reviewed constantly, the speed of which would depend on the young person and their family. There is a rigorous risk assessment process which ensures that compatibility is managed safely.

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Achieving economic wellbeing

The provision is good. Young people are encouraged by staff to develop their independence, providing them with confidence and skills that will support their future well-being. Transitional arrangements for young people to be cared for by adult care services are a significant issue for young people, their parents and the agencies involved. Key workers continue to ensure that transitional review meetings are planned well in advance and reports are available to appropriately represent the young person's care needs. Young people and their parents are fully involved at all stages of the arrangements to leave the service. 7 of 9 Inspection Report: SC034900 This service enables young people to meet friends and new people and lets them experience different activities. Young people are able to socialise and there are opportunities to meet friends out of school, which is seen as a real benefit. Staff provide support for young people

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Achieving economic wellbeing

to be involved in a wide and imaginative range of community based activities, which are easily accessible due to the position of the service.

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Achieving economic wellbeing

The provision comprises two separate units that run independently. The smaller four place unit provides services to young people with physical disabilities and those that require a smaller group and quieter environment. The larger seven place unit provides services to young people that have little or no mobility difficulties and may present challenging behaviours.

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Achieving economic wellbeing

The home is domestic in style and appearance and is friendly and welcoming. The standard and quality of the furnishings are good and meet the needs of the young people placed.

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Organisation

The organisation is good. Young people continue to benefit from a well run and managed short breaks service. The setting operates a partnership approach with young people, their parents, carers and with other professionals. As a result, it contributes to improving outcomes for young people. The Statement of Purpose is current and staff understand the key principles of providing a quality service that takes account of the needs of the young person and the whole family or carer.

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Organisation

The promotion of equality and diversity is outstanding and the staff ensure that each young person is seen as an individual and is treated as such.

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Organisation

A key strength of this home is the emphasis on National Vocational Qualifications (NVQ) with over 96% of the staff team holding the NVQ at level 3 or higher, in child care. A weakness is the ability to maintain staff members' mandatory training on a rolling programme. The management team have reviewed the personal development plans of all staff and identified individual's mandatory training needs in fire awareness, safeguarding, first aid, basic food hygiene and positive intervention. In discussion with the training department, training dates for all staff have been identified.

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Organisation

Young people continue to benefit because there is a highly skilled, caring and competent staff team working at the home. They are very enthusiastic and motivated by their enjoyment of working with young people and watching them progress. The team work well together and possess the skills that they need to look after this client group well. They know the needs of individuals well and how they should be met, ensuring that exceptionally good quality care is delivered.

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Organisation

The staff team work on a rota basis and this ensures the needs of all the young people placed are met. There are enough staff on duty at all times to provide safe care and staff have opportunities to spend quality time with the young people. The rota is amended according to holidays, term time and weekend need. It is also adjusted depending upon the needs of the young people placed together. The manager and staff team are skilled at planning short breaks to ensure there is the right mix of young people staying at any time.

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Organisation

The Registered Manager has a regular cycle of quality assurance activities that produces a range of information about the home's operation. This includes regular external monitoring visits as 8 of 9 Inspection Report: SC034900 well as internal audits of specific areas of service delivery. The staff team are well informed about the overall effectiveness of the service as well as the areas that the home needs to develop or strengthen. A three-monthly summary report provides an overview of how the home is managing to meet the needs of young people who use the service. Outcomes from such reviews and monitoring processes are shared with the staff to ensure key information is acted upon. Young people and parents are regularly asked to comment about the running of the home.

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Organisation

The young people’s files and records are well maintained and structured to provide easy access to information. Each young person’s file contains the necessary information as detailed in Schedule 3 of the Children’s Homes Regulations.

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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

10 June 2010 ensure that staff have access to a programme of continuing training appropriate to the work they perform. (Regulation 27 (4)(a))

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Recommendations

There are no recommendations. 9 of 9 Inspection Report: SC034900

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