Children's Home run by Keys Group Progressive Care & Education Limited in Southampton

SC389180 Unique reference number 18 August 2009 Inspection date David Coulter Inspector Key Type of Inspection

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17 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 9 Inspection Report: SC389180

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Brief description of the service

The home is registered to accommodate up to five young people aged nine to 18 years with multiple disabilities that can include a learning disability, a physical disability and in some cases a sensory impairment. The home provides long-term placements. While the home consists of an older property, it has been extensively renovated and extended to meet the specialised needs of its residents, including those with mobility difficulties. All the young people are accommodated in single rooms on the ground floor. Other facilities include a specially designed garden/play area at the rear of the property. The home is situated in a residential area of Southampton and is well served by public transport. It is also accessible to a range of local amenities and services including a number of Special Schools.

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Summary

Evidence collected during this unannounced inspection indicates that the home is outstanding at assessing and meeting the needs of the young people placed. The specific physical, social and emotional needs of each young person are clearly identified and clear guidance produced for staff on how best they can be met. The health and well-being of each young person is closely monitored on an ongoing basis. Young people are cared for within a pleasant environment that has been specifically designed and equipped to meet the needs of young people with disabilities.

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Summary

Young people live full and active lives and can regularly access activities both within the home and the local community. All the young people have permanent educational placements. The excellent lines of communication staff have established with parents, teachers and placing social workers has led to a greater consistency in approach particularly in respect of behaviour management. The staff are child focused and have developed imaginative ways to seek out the views of young people on all aspects of their care. Staff seek out specialised training in a number of health care procedures to ensure they can meet the needs of young people with complex disabilities. Individual differences are recognised and staff ensure that young people's cultural needs are appropriately addressed. Staff were observed interacting with young people in a warm and affection manner.

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Summary

Evidence indicates that the home is being efficiently managed and that good quality care is being provided by a group of well motivated staff. Staffing levels are appropriate to meet the needs of the current residents. There are well managed records that provide excellent evidence of the work undertaken with young people. All assessed outcome areas are judged as outstanding. 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

Staff have continued to explore different ways of involving young people in the development of the home and have expanded the use of a pictorially based communication system. Important information, such as that relating to fire escape routes, has been produced in the new pictorial format. A new photo board has also been introduced that indicates which staff are on duty during each shift. The purchase of a new minibus that has been specifically adapted to 4 of 9 Inspection Report: SC389180 accommodate wheelchair users has provided more opportunities for young people to access activities in the local community. Staff have continued their knowledge and skills via training and a number have obtained national qualifications. A new policy and procedure relating to the administration of medication has been implemented and is working effectively.

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Helping children to be healthy

The provision is outstanding. The health needs of young people are assessed as part of the admissions process. From the information received, strategies are developed to ensure the health and well being of each young person are appropriately addressed. As all the young people are currently in special education placements some of their health needs are met by specialised staff at their schools. While evidence demonstrates the health and well-being of each young person is monitored on an on-going basis and interventions from health professionals sought to address any concerns, it is recommended that the home develop a single document that indicates how and by whom each young persons specific health needs are being met.

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Helping children to be healthy

As most of the young people have complex health problems, staff have undertaken training in a number of health related procedures to ensure that each individual's specific health requirements can be met appropriately. Procedures for the administration of medication are good and all staff are made aware of any side effects. Consent for all forms of medical intervention have been obtained from appropriate parties.

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Helping children to be healthy

Staff promote the concept of healthy eating and young people are encouraged to eat a balanced diet with appropriate quantities of fruit and vegetables. The home operates a four week rolling menu that incorporates seasonal variations, specific dietary needs and the culinary preferences of each young person. The menu is available in pictorial form. The evening meal is always produced by an experienced cook who uses fresh produce. Young people can access fruit and snacks in between meals. Meals are social occasions and there are facilities for staff and young people to eat together. Staff are always available to assist young people who experience difficulties eating. All staff undertake food hygiene training. Young people are regularly consulted about the home's food and comments cards indicate they are satisfied with both the quantity and quality on offer.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. Due to the nature of their disabilities, young people need assistance with many aspects of their daily lives. Personal care tasks are dealt with sensitively and staff try to ensure each young person is afforded dignity and respect. All young people are provided with their own rooms and there is an expectation that staff will respect 'their space'. For safety reasons, staff often have to check on young people during the night and try and do this with minimal disruption. Confidential information relating to each young person is stored in an appropriately locked facility.

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Protecting children from harm or neglect and helping them stay safe

The home has a written complaints policy that is reproduced in pictorial form for young people. If a complaint is made it is immediately logged and reported to the manager. The actions taken to resolve complaints is noted and feedback provided to complainants within a reasonable timescales. Staff aim to avoid complaints developing by maintaining good lines of communication 5 of 9 Inspection Report: SC389180 with parents and placing authorities. Pictorial questionnaires are used on a regular basis to ascertain the views of young people on all aspects of their lives within the home.

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Protecting children from harm or neglect and helping them stay safe

Due to the vulnerability of the young people it accommodates, the home has developed a range of policies and procedures to keep them safe. A well developed child protection policy provides clear guidance on how to both identify and report child protection concerns and staff are aware of their personal responsibilities. By the use of appropriate staffing levels, behaviour management strategies and close supervision, staff aim to minimise risk. Policies have been developed on potential areas of concern such as bullying and absconding. A written record is made of all serious incidents and all appropriate authorities such as Ofsted and Social Services notified. No serious incidents have occurred since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Staff encourage young people to develop their social and life skills. Positive behaviour is reinforced by staff and individual behaviour management plans provide a consistent approach. Sanctions are not extensively used and are only applied if it is felt a young person can comprehend the reason. All sanctions are recorded in a dedicated book and monitored regularly. Though all staff have undertake training in the use of physical interventions they are only ever used if it is felt a young person is putting themselves or others at risk.

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Protecting children from harm or neglect and helping them stay safe

The home operates within a risk management framework in which risk assessments are extensively used to ensure the safety of both young people and staff. Risk assessments are used in relation to activities both in the home and in the community. Risk assessments are subject to regular review and updated in response to any incidents. Fire safety equipment is subject to regular checks and full evacuations are undertaken.

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Protecting children from harm or neglect and helping them stay safe

Access to the building is limited and all visitors have to report to staff on admission, produce identification and sign in. There is a small secure garden area to the rear of the property.

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Protecting children from harm or neglect and helping them stay safe

The home operates with a stable team of permanent staff who are supported by a number of agency staff who are familiar with both the residents and working practices within the home. Staff are recruited via a well established recruitment process that requires a comprehensive range of checks being undertaken. All prospective staff also have to successfully complete a training programme before being appointed. The manager explained that every effort is made to draw staff from across the local community. The current staff team contains a good balance of males and females.

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Helping children achieve well and enjoy what they do

The provision is outstanding. A key and co-worker system ensures that the specific physical, social, and emotional needs of each young person are continuously monitored. Though staff are allocated as key and co-workers for specific individual's, there is an expectation they will be conversant with needs of all residents. The well-being of each young person is documented daily and compiled into weekly and monthly reports. If the monitoring process identifies a need that can not be met by staff within the home, assistance is sought from a range of professionals that include speech therapists, physiotherapists and paediatricians. There are well established communication systems to ensure that important information is shared between staff on different shifts and forwarded onto interested parties such as parents, teachers and placing social workers. 6 of 9 Inspection Report: SC389180 Given the complex nature of their disabilities, the homes current residents have been identified

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Helping children achieve well and enjoy what they do

as having special educational needs. All have full-time placements in local schools. Evidence indicates that staff regularly liaise with teaching staff to ensure that key information is appropriately shared and a consistency in approach is being followed by both staff teams. The homes staff attend educational reviews.

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Helping children achieve well and enjoy what they do

Young people are encouraged to live full and active lives and are supported in experiencing a range of social and recreational activities in both the home and local community. A number of the young people regularly attend both the cubs and a local youth club. The home has its own transport that is used to support social and recreational activities.

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Helping children make a positive contribution

The provision is outstanding. The home has a written admission procedure that aims to help each young person settle in effectively. Young people and their families are encouraged to undertake a number of visits before seeking admission. Young people are provided with a young person's guide on admission. There is an expectation that leaving the home will be a planned process and young people will follow a transition plan.

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Helping children make a positive contribution

The assessment of young people's needs is comprehensive and forms the basis of placement plans. Young people are involved in the development of their placement plans and are helped in creating pen pictures detailing, amongst other things, their likes and dislikes. Placement plans are divided into specific outcome areas and provide guidance for staff on how each individual's care needs should be met. Placement plans are closely monitored and reviewed in line with looked after children guidance. Young peoples views are sought prior to any review and represented in a report prepared by their key and co-worker. Any outcomes/recommendations arising out of reviews are incorporated into the placement planning process. Though communication with a number of the young people can be difficult, staff employ a number of methods in order to explain any decisions made.

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Helping children make a positive contribution

Individual placement plans provide clear guidance for staff on the type and frequency each young person can have with their parents, relatives and friends. All the current residents maintain regular contact with their families. Any restrictions regarding access are, when appropriate, made clear to all parties. Staff will, if required, assist young people by providing transport for their trips home.

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Helping children make a positive contribution

On the day of the inspection a number of young people undertook a visit to a theme park. Prior to their departure it was possible to observe the preparations. Staff were clearly conversant with the non-verbal behaviour of the young people they were caring for and kept them informed of what was happening. The trip was risk assessed and there were appropriate staffing levels to ensure each young person would get personal attention.

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Achieving economic wellbeing

The provision is outstanding. While the home has a policy to assist young people make the transition into adulthood. Though social and life skills training is tailored to the needs and capabilities of each individual, there is a realisation that, due to the complexity of their disabilities, many of the young people will continue to need assistance with many daily living tasks. Staff are clearly aware of the 7 of 9 Inspection Report: SC389180 vulnerabilities of each individual and risk assess all training activities. Transition plans, that cause minimal disruption and stress are developed with members of Local authority After Care teams.

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Achieving economic wellbeing

The home is situated in a good location that is accessible to a range of local facilities. The home is specifically designed and equipped to meet the care needs of young people with disabilities. Each young person has their own room that has been decorated and furnished to meet their specific needs. There are a number of communal areas that include a lounge and dining room. The home is subject to regular maintenance and health and safety risk assessments. There is current certification relating to gas, electrical and fire equipment.

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Organisation

The organisation is outstanding. The home has produced a comprehensive statement of purpose that accurately reflects the nature of the service on offer. The statement of purpose is subject to an annual review. An excellent young person's guide has also been produced in a pictorial format for young people with communications difficulties. Young people are supplied with a guide as part of the admission process.

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Organisation

The home operates with a permanent staff team who have the skills, qualifications and experience to meet the needs of the young people presently accommodated. Staff are clearly aware of their individual roles and responsibilities. Staffing levels are adjusted in line with the changing needs of young people. Risk assessments are used to identify appropriate staffing levels for activities in the local community. Each shift is managed by a designated experienced member of staff. Due to the needs of the young people the home operates with waking night staff.

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Organisation

There is a culture of training and professional development within the home and an expectation that each member of staff will increase their knowledge and skills on an on-going basis. Training opportunities are excellent and staff can access a wide range of courses from an annual training programme. Specialist training is provided by health professionals to ensure staff are conversant with the medical conditions young people experience and the delegated health tasks needed to support them. Staff receive regular supervision and an annual appraisal. A comprehensive range of policies and procedures provide staff with clear accessible guidance. There are regular staff meetings and minutes taken.

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Organisation

The manager provides effective leadership and employs a 'hands on' management style. She works alongside staff on different shifts and has daily contact with the young people. The operation of the home is monitored internally by the manager and externally by another New Horizon's home manager who compiles a written report each month. The monitoring system is extremely effective and any issues identified are immediately addressed.

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Organisation

Evidence obtained during the inspection indicates the home is operating effectively and the well motivated staff team provide excellent care to a group of young people with complex care needs. The promotion of equality and diversity is good and staff regularly provide opportunities for young people to experience a range of cultural experiences. There is an excellent recording system and all aspects of each young person's placement is well documented. Records examined contain recent and relevant information and are kept in an appropriately locked facility. 8 of 9 Inspection Report: SC389180

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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

There are no recommendations. 9 of 9 Inspection Report: SC389180

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