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

SC389174 Unique reference number 24 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: SC389174

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Brief description of the service

Galena is a children’s home that offers short term respite placements for up to eight young people who may have learning disabilities, physical disabilities, complex health needs and/or autism and associated challenging behaviours. The home, a large detached property, has been specifically converted and extended to meet the needs of the young people it accommodates and contains specialised facilities, such as a sensory room, outside play area and specially designed bathrooms. The home is situated in a residential area of Southampton and is accessible to a range of services and facilities including parks, health centres, schools and shops.

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Summary

The inspection took place on a busy day during the school holidays when the home was fully occupied. Evidence collected during this unannounced inspection indicates the home is operating effectively and is providing good respite care for a group of young people, many of whom have complex needs. Staffing levels were at a level to allow young people to undertake activities in the local community.

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Summary

Staff spoken with during the inspection were clearly aware of their roles and responsibilities. All were able to speak with authority about the specific needs of the young people they were caring for. Staff confirmed they had undertaken training to enable them to carry out delegated health tasks.

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Summary

A tour of the premises indicated that the home is structurally sound and in good decorative order. The home offers a relaxed and stimulating environment in which young people are assisted in developing their social and life skills. Young people's rooms are furnished to meet their needs and specialised equipment is available. Good systems have been developed to ensure that medication is stored and administered appropriately.

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Summary

There are two actions arising from this report, neither of which impacts directly on the quality of care being offered. Feedback from parents and placing authorities indicates a high degree of satisfaction with the service. Evidence indicates that the home is being efficiently managed and that good quality care is being provided by a group of experienced and well motivated staff. 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

As this is the first key inspection since the home's registration no improvements have been registered.

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Helping children to be healthy

The provision is good. Staff promote the concept of healthy living and young people are encouraged to eat a balanced diet with appropriate quantities of fruit and vegetables. Special dietary needs and individual preferences are incorporated into the menu planning process. Young people are provided with opportunities to assist staff in the preparation of food. The evening meal is produced on the 4 of 9 Inspection Report: SC389174 premises by an experienced cook who uses fresh produce. It was noted that one of the work surfaces in the kitchen was damaged and it is recommended that this is made good. 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. Evidence indicates young people are satisfied with both the quantity and quality of food on offer.

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Helping children to be healthy

The physical, social and emotional needs of young people are identified as part of the home's admissions process. The home has developed policies and effective working practices to ensure the health and well-being of each young person is appropriately addressed during their stays. As young people are only resident for respite stays, responsibility for meeting their health needs normally rests with their parents. Consents for medical interventions are obtained in advance of any admission. If required staff will accompany young people to health appointments and access parents and health professionals for advice. Staff are made aware of the particular health difficulties associated with each young person's disability and undertake specific training to address any delegated health related tasks.

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Helping children to be healthy

Being a respite service staff are acutely aware of the difficulties associated with having to manage the flow of medication in and out of the home. In response, an effective recording system has been developed to ensure that all medications are accounted for on a daily basis. All staff undertake specific training on the administration of medication. There are good procedures in place to ensure that medication is both dispensed and stored appropriately. Information is provided for staff on the nature of each medicine and possible side effects.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Staff aim to ensure that young people are afforded privacy during their respite stays and all young people are allocated a room of their own which is designated as 'their space'. Staff ensure that each young person's room is specifically furnished to meet their needs in advance of their stays. Due to the nature of their disabilities, many of the young people need assistance with aspects of their daily lives. For example, some young people require regular checking at night and staff try to carry out such checks with minimum disruption. Staff also carry out personal care tasks sensitively and bathroom doors are always kept closed. Confidential information relating to each young person is kept secure in an appropriate 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 placing authorities, parents and young people are made aware of on admission. All complaints are logged and the actions taken to resolve them noted. Records indicate that complaints are taken seriously and that complainants receive appropriate feedback within a reasonable timescale. By regularly employing a range of communication techniques, staff aim to seek out the views of young people about their experiences of life in the home. The manager also seeks out the views of parents and placing authorities via an annual questionnaire. Respondents to the last questionnaire indicated a high degree of satisfaction with the service.

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Protecting children from harm or neglect and helping them stay safe

The home has developed policies to ensure young people are kept safe during their respite stays. All staff have completed child protection training and are aware of their personal responsibilities in regard to the reporting of child protection concerns. By the use of appropriate staffing levels, behaviour management strategies and close supervision, staff aim to minimise 5 of 9 Inspection Report: SC389174 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.

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Protecting children from harm or neglect and helping them stay safe

Behaviour management plans are developed in respect of each young person and provide staff with guidance that leads to a more consistent approach. Staff respond positively to acceptable behaviour and sanctions are only applied if it is felt that the young person has insight into their behaviour. The most common form of sanction is 'time out' when a young person spends time in their own room. All sanctions are recorded in a dedicated book. Though staff receive training in the use of physical restraint; such intervention is only ever used if it is felt a young person is in danger of hurting themselves or others. Staff normally use diversionary techniques when confronted with challenging behaviour. The behaviour of each young person is regularly discussed by staff.

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Protecting children from harm or neglect and helping them stay safe

The home operates within a risk management framework. Risk assessments are extensively used to ensure the safety of both young people and staff. Risk assessments are subject to regular review and updated in response to any incidents. The home is subject to a range of inspections from bodies such as Environmental Health and Fire Safety. Records demonstrate that equipment, including the home's fire alarm system, is tested regularly and subject to regular maintenance. Staff regularly undertake evacuation drills. Access to the building is restricted and all visitors have to report to staff on admission. The home has appropriate liability insurance.

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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 the company's own agency staff. The majority of agency staff are familiar with both the residents and the working practices of 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. While staff are drawn from across the local community and contain a good balance of males and females from a range of social and ethnic background, the management team would like to recruit a number of older staff.

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Helping children achieve well and enjoy what they do

The provision is outstanding. As the home's resident group can change on a daily basis, systems have been developed to ensure that information relating to the care of each young person is available for staff. While staff on different shifts are allocated to work with specific young people, there is an expectation they will be conversant with the needs of the young people in residence.

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Helping children achieve well and enjoy what they do

During the inspection it was possible to observe the interaction between staff and young people. Young people appeared to be relaxed and at ease in their surroundings. They were being cared for by staff who were extremely attentive to their needs. Staff monitor the well-being of each young person and there are effective communication systems in place to ensure that important information is shared between all interested parties including parents and social workers.

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Helping children achieve well and enjoy what they do

As young people are only accommodated for short periods, staff are not involved directly in young people's education, however, they frequently liaise with parents and school staff to ensure they can access their normal educational placements. 6 of 9 Inspection Report: SC389174 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. The home has its own transport that is used to support social and recreational activities. Staff support young people in developing their interests and hobbies and will accompany them on activities such as swimming, country walks and trips to the cinema. While there is an outside play area to the rear of the property, consideration should be given to providing equipment that is more age appropriate.

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Helping children make a positive contribution

The provision is good. The home has developed a comprehensive admissions process that aims to identify those young people who would benefit from respite visits. Young people are expected to visit in advance of any placement. If it is felt a placement is appropriate, a more detailed assessment is initiated. From the information received placement plans are developed that clearly identify the care needs of each individual and provide staff with guidance on how they can be effectively met. Placement plans are regularly monitored and updated in response to changing circumstances. The views of young people, their parents and placing social workers are sought as part of the normal reviewing process. Any recommendations arising out of reviews are incorporated into the placement planning process. Staff work with members of local authority after care teams to develop transition plans.

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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. As most placements are short, families do not frequently visit. However, those on holiday placements from residential schools often receive visitors. Any restrictions regarding access are, when appropriate, made clear to all parties.

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Achieving economic wellbeing

The provision is good. The home aims to make young people's stays as enjoyable and productive as possible. Young people are encouraged to experience new activities both within the home and in the local community. While 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 require assistance with some daily living tasks. Staff are clearly aware of the 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 good. 7 of 9 Inspection Report: SC389174 The home has produced a comprehensive Statement of Purpose that accurately reflects the nature of the service on offer. The Statement of Purpose has been recently updated to reflect changes in the way the service operates. The statement is subject to an annual review. A 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 admissions process.

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Organisation

The home operates with a team of permanent staff who are supported by a group of experienced agency workers. All staff have completed the company's initial training programme. Staff are deployed in sufficient numbers to ensure the needs of young people are being adequately met. Each shift is managed by a shift leader who determines the role and responsibility of each staff member. Staff shifts overlap to ensure adequate time for staff to carry out thorough handovers. Staffing levels are continuously monitored and increased in line with need. For example, staffing levels are increased during the school holidays when the home is fully occupied. All external activities are subject to a risk assessment process to determine appropriate staffing levels.

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Organisation

There is an expectation within the home that staff will keep their knowledge and practice updated by accessing regular training opportunities. All new staff must complete a comprehensive induction programme and demonstrate their competence before assuming their full duties. Staff can access training through the company's own training programme which offers a wide range of courses. 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. A record is kept on staff files of all courses attended. While many staff have completed National Vocational Qualifications at Level 3, it was noted that a number of permanent staff, who have been employed for more than two years, have still to do so. Staff receive regular supervision and an annual appraisal. There are regular staff

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Organisation

At the time of the inspection the Registered Manager was about to embark on a short secondment from within the company to help establish another service. Arrangements have been established to ensure that the home is managed effectively. The deputy manager and a number of experienced senior staff are assuming responsibility for daily operations. The home is subject to a number of internal and external monitoring systems that include monthly visits by another experienced home's manager. The monitoring system is working well and monitoring reports indicate that identified issues are dealt with within an appropriate timescale.

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Organisation

Evidence obtained during the inspection indicates the home is operating effectively and providing good quality respite care. The staff team are well motivated and are continually looking at new ways to make young people's respite stays both stimulating and enjoyable. 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 efficient recording system and all aspects of each young person's placement are well documented. Records examined contain recent and relevant information and are kept in an appropriately locked facility. 8 of 9 Inspection Report: SC389174

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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

30 March 2010 ensure all staff complete their NVQ level 3 training (Regulation 25) 10 December 2009 ensure that the damaged kitchen surface is made good (Regulation 23)

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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): • give consideration to installing more age appropriate outside play equipment (NMS 15) 9 of 9 Inspection Report: SC389174

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