Children's Home run by London Borough of Hounslow in Hounslow

SC032600 Unique reference number 26 August 2009 Inspection date Paula Eaton 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: SC032600

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Brief description of the service

This short-breaks service provides care for up to five children who have either physical and/or learning disabilities and also may have a sensory impairment, aged between 10 and 19 years of age. The home is owned and operated by a local authority. The home is located in a residential area close to local shops, a library and local swimming pool. The home also has good transport links into the town centre.

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Brief description of the service

The ground floor of the home has a communal area that has a comfortable seating area, dining area, pool table and football table. There is also a sensory room and soft play area on the ground floor, as well as the shift office, kitchen, laundry room, bathroom and activity room with computer equipment for children to use. All of the bedrooms are situated on the first floor along with further bathroom facilities and offices. There is a rear garden with play equipment for children to use and a sensory garden. The home has appropriate adaptations to meet the needs of children with physical disabilities that use the service.

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Brief description of the service

There were three children at the unit at the time of the inspection and staff were observed interacting with these children.

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Summary

The standard of care and individualised support provided for children in the unit is excellent. Staff are proactive and creative in their approach to caring for children and are motivated and committed to providing a safe, fun and educational environment. A holistic approach is taken to the care of each individual child and any changing needs are observed and promptly addressed. Although children only reside at the home for short periods of time staff take an active interest in their overall wellbeing and development and strive to support them to reach their potential.

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Summary

Management and monitoring systems within the service are also of an excellent standard and detailed records are maintained and kept up to date. The service has a consistent record of improvement and development and continues to seek ways to improve the service for children. 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

There were no actions set at the previous inspection. The unit consistently provides an excellent service for children and their families and staff are continuously striving to improve the standard of care provided.

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Helping children to be healthy

The provision is outstanding. Careful attention is paid to the dietary needs and preferences of children including any cultural or religious observances. Nutritious well balanced meals are provided and specialist diets are catered for. For example, the unit has provided specific meals to ensure continuity with special diets children have been put on to help with particular medical conditions. Very detailed information is recorded about the dietary needs of children including any allergies they may have. This information is kept in a file in the kitchen as well as in children's case files so that 4 of 9 Inspection Report: SC032600 the information is readily available for those people preparing food for children. Individual diets are closely monitored especially where there are health concerns and staff encourage children to try new foods and eat healthily. Careful consideration is also given to the support

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Helping children to be healthy

children require with eating and drinking to ensure that they enjoy mealtimes and remain as independent as possible.

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Helping children to be healthy

As the unit is a short breaks provision parents and carers generally remain responsible for meeting the healthcare needs of their children. However, care plans contain very comprehensive details of each individual child's healthcare needs and any action staff should take to meet these. The unit often supports children with very complex medical conditions and care is taken to develop clear guidelines to ensure that staff are consistent in their practice. This contributes to enhancing the wellbeing of children who use the service. Staff work very closely with children and their families and as a result are prompt to identify and address any changes in the wellbeing of children. Staff support families to seek professional healthcare support when required and maintain good links with all those involved in the care of individual children to ensure a consistent approach to their care.

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Helping children to be healthy

Staff also receive regular training to ensure they are appropriately skilled to meet specific health needs. For example, staff receive training on the use of Gastronomy devices and epilepsy and the Registered Manager invites healthcare professionals to team meetings to provide advice and guidance on specific issues. The majority of staff hold a paediatric first aid qualification and all staff receive training on food hygiene.

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Helping children to be healthy

Robust systems are in place for the safe storage, administration and disposal of medication. Staff receive medication awareness training and new staff are fully supported in the administration of medication until they have the confidence, skills and experience to safely carry out these duties. Staff also monitor the affect of medication and pass relevant information on to parents and healthcare professionals where relevant.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. The privacy and dignity of children is prioritised within the unit taking into consideration the individual needs and preferences of children with regard to their personal space and support needs. Staff support children to be as independent as possible to avoid any unnecessary intrusion of their privacy. Appropriate policies and procedures are in place with regard to confidentiality and these include clear guidance for staff about their responsibilities in relation to dealing with sensitive information.

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Protecting children from harm or neglect and helping them stay safe

A robust complaints procedure is in place. Parents, staff and children are made aware of their right to complain if they are unhappy with any aspect of the service and any complaints made are taken seriously and dealt with promptly. A detailed record is maintained of any complaints made including any action that has been taken and the outcome of the complaint. The level of complaints for the unit is very low and the records maintained are monitored by the Regulation 33 visitor.

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Protecting children from harm or neglect and helping them stay safe

Staff are very clear about their responsibilities with regard to safeguarding children and promptly report any concerns that they may have. Clear policies and procedures are in place and staff receive regular training updates on child protection matters. This includes training that supports the specific needs of staff working with children with disabilities. Staff monitor relationships 5 of 9 Inspection Report: SC032600 between children and address any issues as soon as they arise to minimise any incidents of bullying and the impact this may have. Bullying is rare within the unit and incidents between children are often as a result of difficult behaviours displayed rather than bullying. Absconding within the unit is almost non-existent as staff ratios are high and the building secure to keep children safe as a result of their complex needs and vulnerabilities. However, risk assessments are completed for any child where there is an identified risk of them absconding and action is

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Protecting children from harm or neglect and helping them stay safe

All staff receive regular training on behaviour management techniques including physical restraint. Very thorough processes are in place that ensure any challenging behaviour is addressed in a positive manner in the best interests of the child and others who use the service. Individual placement plans include information about how to encourage positive behaviour. Sanctions are only imposed if they are meaningful to the individual child involved and are dependent on the level of understanding of that child. The service also takes a multi-agency approach to behaviour management, liaising with healthcare professionals to ensure that methods used are as effective as possible. The Registered Manager and Regulation 33 visitor also monitor all records relating to behaviour management and take action to address any noted issues or questions raised.

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Protecting children from harm or neglect and helping them stay safe

Comprehensive health and safety policies and procedures are in place and are adhered to by staff. Detailed records are maintained for all health and safety checks that take place and these are carried out at the required regular intervals. The service also carries out very thorough risk assessments of any possible or identified risks to children and reviews and updates these regularly to ensure that the welfare and safety of children is maintained at all times.

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Protecting children from harm or neglect and helping them stay safe

Robust recruitment policies and procedures are in place and all required checks are completed prior to individuals commencing work to ensure that children are appropriately safeguarded. All recruitment is carried out by the local authority human resources department.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Staff strive to meet the individual needs of children in a constructive and creative manner taking particular note of their cultural and religious needs and incorporating this into the daily routine of the home. All children are allocated a key worker who takes responsibility for ensuring that their care plans are up to date and individual needs met. Risk assessments are completed in relation to risks identified for individual children and careful consideration is given to providing stimulating, challenging and enjoyable activities that take into consideration individual strengths and preferences. Children are encouraged to take controlled risks to support them in reaching their potential and achieving as much independence as possible. Comprehensive informative daily records are maintained that clearly indicate the young person's experiences whilst staying at the unit.

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Helping children achieve well and enjoy what they do

As a short-breaks service parents and carers retain responsibility for the education of the children who use the service. However, staff liaise with educational placements regarding the care of children and strive to support them to achieve and reach their potential. For example, children may be given responsibility for certain tasks within the unit or supported to reach specific goals identified within their care plans. Staff also support children with their homework where appropriate and maintain a copy of school reports. 6 of 9 Inspection Report: SC032600 The service has a wealth of activities available to children within the unit. The rear garden contains outdoor play equipment that is accessible to children with disabilities including a sunken trampoline, a wheelchair swing and a roundabout. There are also two tricycles that children enjoy using and a sandpit and sensory garden are also available. Indoors there is a

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Helping children achieve well and enjoy what they do

football table, pool table and games console available as well as ample games, books, toys and computers. Staff also support children to access leisure activities in the community that they would otherwise not be able to use for a variety of reasons. The needs and preferences of individual children are always considered when planning activities. On the day of the inspection children enjoyed a trip to Kew Gardens.

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Helping children make a positive contribution

The provision is outstanding. The needs of children are assessed prior to them using the service and detailed care plans are developed and then updated as staff get to know children and their needs change. Each child is allocated a key worker who is responsible for maintaining their care plan. The detail in care plans is such that they provide a clear picture of the child, their personality, preferences and influences as well as comprehensive information about their basic care needs. The care plans promote and protect the welfare of children and encourage their individuality. Clear objectives are in place along with clear guidance for staff about the best way to meet the needs of the children.

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Helping children make a positive contribution

Staff take an active role in statutory reviews for children and the management team also contribute to these. Children are encouraged to contribute where possible and staff routinely advocate on behalf of children in this forum. Detailed review reports are completed for review meetings and actions agreed during the meeting are promptly followed up by staff and monitored by the management team.

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Helping children make a positive contribution

Children generally live with their families and only attend the unit for short periods of time to provide a break for the children and their families. Therefore it is not part of the service remit to arrange contact. However, parents and carers are able to maintain contact with children whilst they are staying at the unit and clear information is recorded in placement plans regarding any restrictions on contact that are in place.

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Helping children make a positive contribution

Very clear protocols are in place for introducing children to the unit. Visits to the unit take place, such as tea visits so that children can familiarise themselves with staff and their peers and children are able to meet with their key worker during this time. Staff also ensure that children are fully supported when they move on from the unit into adult services. For example, a slow induction takes place where the child will visit for short periods of time and the Registered Manager liaises closely with the new service to ensure that they are aware of the child's needs.

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Helping children make a positive contribution

The individual communication needs of young people are clearly recorded to ensure that they can be actively involved in any decision making wherever possible. Questionnaires are adapted taking into consideration the most effective means of communication for individual young people so that they are able to contribute their views regarding the service provided at the unit. Parents and carers and other stakeholders are also encouraged to express their opinions about the service and an open and transparent system of working is adopted by the unit. The unit arranges a communication day that involves seeking the views of parents, carers and children in a creative and fun way whilst still enabling them to do this confidentially if they wish. At the recent communication day the focus was 'being healthy' and included football 7 of 9 Inspection Report: SC032600 classes and drama therapy as well as a party in the afternoon. A suggestion box was provided

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Helping children make a positive contribution

for views to be shared during the day and alternative arrangements were made to seek the views of those children and parents unable to attend the event.

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Achieving economic wellbeing

The provision is good. Care plans show that children are encouraged to develop self-help skills and become as independent as possible. Staff are creative in the way they do this using the interests of young people to motivate them. The unit liaises closely with the local authority to ensure that children are prepared and supported as much as possible with the move into adult services.

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Achieving economic wellbeing

The unit is located in a residential area close to local community resources. There is a local swimming pool very close to the unit as well as local shops and the unit is a short distance from the local town centre. There are also social work teams located close to the unit which supports multi-agency working. The house is appropriately adapted to meet the needs of the children who use the service and all equipment is maintained to a good standard.

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Achieving economic wellbeing

The furniture and décor within the unit is of a good standard. Some new furniture has been purchased since the last inspection including furnishings for some of the bedrooms. Any maintenance issues are promptly reported and addressed. Each bedroom has a colour theme and children where possible are given a choice of what room they will stay in. Children are encouraged to bring personal belongings with them for their stay at the unit. The unit has computers in a study room in the communal area downstairs and there are rooms available for visitors to meet in private.

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Organisation

The organisation is outstanding. The Statement of Purpose for the unit is kept up to date and contains all of the required information. There is a children's welcome guide that is produced in the form of a DVD that provides a more appropriate visual and auditory guide to the unit for the children who use the service.

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Organisation

The promotion of equality and diversity is outstanding. The service strives to provide a service tailored to meet the specific individual needs of children and promotes a holistic approach to working with children that considers all aspects of diversity. Staff are knowledgeable about the needs of children and are consistent in their proactive approach to meeting these for individual children seeking professional support and guidance where required.

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Organisation

All but recently recruited staff members have completed their National Vocational Qualification Level 3. There is a formal handover period between shifts that ensures that all relevant information is passed on to inform planning for the shift ahead. Appropriate risk assessments are in place for lone working, although this is a rare occurrence and there are senior staff available at all times. The service has a good line management structure and clear lines of accountability ensure that staff are effectively managed which contributes to the excellent service provided for children.

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Organisation

Clear training records are in place for staff. The Registered Manager ensures that staff attend core training as well as training that meets the specific needs of children who use the service. 8 of 9 Inspection Report: SC032600 This training is delivered in a variety of ways and from a variety of sources and the Registered Manager is creative and determined in ensuring that staff are equipped with the appropriate information and skills to meet the needs of children. For example, healthcare professionals are invited to team meetings and additional training is sought externally to enhance general training with specifics about meeting the needs of children with disabilities. Recently organised training has included recognising and responding to non-accidental injuries, toileting programmes and training on play and activities. There is a comprehensive induction programme in place for any new member of staff that involves experienced senior staff working with new staff to ensure

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Organisation

their understanding of the systems and procedures within the unit.

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Organisation

Excellent monitoring systems are in place that cover all aspects of the day to day running of the unit. The Registered Manager regularly monitors and comments on all records and takes steps to address any inconsistencies or shortfalls. Regulation 33 visits are also carried out on a monthly basis and detailed reports prepared and prompt action taken to address any issues identified.

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Organisation

Secure records are maintained for young people and these contain all of the required information.

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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: SC032600

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