Children's Home run by Bristol City Council in Bristol

SC031504 Unique reference number 29 March 2010 Inspection date Thomas Webber Inspector Key Type of Inspection

p.1

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.

p.2

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

p.2

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.

p.3

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: SC031504

p.3

Brief description of the service

This home provides care and accommodation for up to 10 children and young people, aged five to under 18 years who have a learning disability and who may also have a physical disability. The home provides overnight short breaks.

p.4

Brief description of the service

The home is primarily divided into two units each catering for a different age group, although there is some flexibility within these to meet the needs of children and young people. One unit primarily provides care for five to 12 year olds with the other providing care for 12 to under 18 year olds. However, there are times where both groups of children and young people mix together for activities, meals or outings where appropriate.

p.4

Brief description of the service

The home is situated in an urban residential area and has its own transport facilities.

p.4

Summary

This unannounced, key inspection took place over one day. The inspection covered all of the children's homes key standards. This forms part of the annual inspection programme to examine the standard of care and services provided to children and young people. At the time of inspection, eight children and young people were accommodated.

p.4

Summary

The home provides a good standard of care to children and young people which ensures that good to outstanding outcomes are achieved for them. This is endorsed by observations made and records seen. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

p.4

Improvements since the last inspection

One action and two recommendations were made at the last inspection. The recommendation relating to the sanctions and physical intervention logs has been complied with. Some improvements have been made in relation to the recommendation relating to the continuity of care by staff.

p.4

Improvements since the last inspection

The action relating to the heating and hot water supply to the home has not been complied with and, although action is now being taken to address the deficiency, major works will not be completed until mid August 2010. In the meantime, interim arrangements will need to ensure that the home is adequately and consistently heated with sufficient quantities of hot water being provided.

p.4

Helping children to be healthy

The provision is good. Staff support children and young people to eat a healthy and balanced diet. Varied and satisfactory menus are produced to reflect this. The menus take into account the likes and dislikes of children and young people as well as various international options. Individual sheets are also maintained which record meals eaten by children and young people. Pictures of the meals provided are on display in the dining rooms together with the Makaton symbols to assist those children and young people who require a visual aid. Fresh fruit is also readily available. 4 of 9 Inspection Report: SC031504 Children and young people are provided with opportunities to be involved in the preparation and cooking of some meals within their capabilities and with the support of staff.

p.4

Helping children to be healthy

Due to the nature of the placements at the home, the parents/carers of children and young people maintain responsibility for ensuring that their health care needs are met. However, policies and procedures are in place to ensure that the children and young people's health care needs are met in the event of an emergency. If children and young people are unwell during their stay, their parents/carers are contacted in the first instance. However, where they are unavailable, staff would access the local health care centre to deal with the situation. Parental medical consent forms are established for this purpose.

p.5

Helping children to be healthy

The home ensures that the welfare of children and young people in relation to medication is safeguarded. Appropriate policies, procedures and systems are established for the safe storage, receipt and administration of medication. Staff receive training in the safe administration of medication and administer all medication to young people.

p.5

Protecting children from harm or neglect and helping them stay safe

The provision is good. Staff respect the children and young people's rights to privacy and dignity which are balanced with the need to offer them the protection and safety they require. Most children and young people require some form of care and support, including help to meet their physical needs. Children and young people's records are stored securely and staff understand the need to keep their information confidential as well as being clear about the limits of confidentiality.

p.5

Protecting children from harm or neglect and helping them stay safe

Clear policies and procedures are established for dealing with complaints. These are produced in suitable formats for adults, children and young people. Parents/carers are encouraged to raise any concerns they have about their children and young people's care. A comments box is also available within the home to encourage feedback from parents/carers and professionals. Three complaints have been received since the last inspection. Records show that although all complaints are usually responded to and addressed without delay, insufficient information is recorded and not all complaints are recorded in the complaints log. One compliment of appreciation has also been received about the care and support provided by the staff.

p.5

Protecting children from harm or neglect and helping them stay safe

Children and young people live in a safe environment where their welfare is promoted. Staff have a very good understanding of their needs and how to safeguard them. Suitable policies and procedures are in place in respect to child protection which comply with the Local Safeguarding Children Board procedures. All staff have either received child protection awareness, through their induction, or appropriate training in this area of practice.

p.5

Protecting children from harm or neglect and helping them stay safe

An anti-bullying policy is established which ensures the protection of children and young people from bullying.

p.5

Protecting children from harm or neglect and helping them stay safe

Bullying is not currently seen as an area of concern. Staff remain vigilant and are aware of the children and young people's needs. They know the effect the behaviour of specific combinations of children and young people can have on each other and are aware of the need to monitor this in such circumstances. An anti-bullying resource pack is available and is used with individuals or on a group basis depending on the children and young people's ability and understanding to work through the effects of their behaviour. 5 of 9 Inspection Report: SC031504 Children and young people who are absent without authority are suitably protected. A clear system is established for the reporting and recording of any event where they go absent without consent. There have been no reported incidents since the last inspection.

p.5

Protecting children from harm or neglect and helping them stay safe

Clear guidelines, protocols and strategies are established to manage any challenging behaviour of the children and young people. The home is pro-active in identifying triggers so that staff can take positive action to help children and young people to manage their behaviour more appropriately. A positive handling plan is also established for those who have specific challenging behaviours. Children and young people's negative behaviours are regularly monitored, recorded and dealt with in an agreed way by staff. Staff receive physical intervention training which is used as a last resort unless it has been identified as the agreed strategy to deal with the specific behaviours of children and young people. All records of sanctions and restraints are now

p.6

Protecting children from harm or neglect and helping them stay safe

regularly monitored by management. However, the time is not always recorded.

p.6

Protecting children from harm or neglect and helping them stay safe

Robust health and safety policy and practice guidelines are in place to ensure that the staff, children and young people are appropriately safeguarded. No specific health and safety issues were identified during a tour of the premises. Children and young people and staff regularly practise fire evacuation procedures and the various fire safety records are accurate and up to date.

p.6

Protecting children from harm or neglect and helping them stay safe

Robust staff recruitment practices are established for the careful selection and vetting of all new staff to ensure the protection of children and young people. New staff do not commence employment in the home until all the relevant checks have been carried out.

p.6

Helping children achieve well and enjoy what they do

The provision is outstanding. Children and young people receive the level of support based on their individual needs. These are well documented in their respective care plans which provide staff with clear information on how best to meet their individual needs and preferences. All children and young people are allocated a key worker who is responsible for coordinating the implementation of their respective care plans. The key worker also maintains regular contact with their parents/carers, social workers and schools to ensure that children and young people's needs are being met.

p.6

Helping children achieve well and enjoy what they do

The home actively promotes the education of children and young people with them all attending their respective school placements each day. The educational needs of children and young people are overseen by their parents/carers. However, staff also attend the children and young people's school reviews wherever possible. Transport to and from school is divided between the home and the various schools. Staff also visit prospective children and young people at their schools to obtain all relevant information to assist them to settle into the home once a place is offered.

p.6

Helping children make a positive contribution

The provision is outstanding. The home provides short term overnight breaks to support families who care for children and young people with physical and learning disabilities. The home offers flexible care packages in consultation with children and young people, their parents/carers and other relevant professionals. Staff make visits to the family homes and schools prior to introductory visits 6 of 9 Inspection Report: SC031504 being made to the home by children and young people together with their parents. This together with information obtained from their respective social workers forms the home's comprehensive assessment/care plans which focuses on short-term goals and is reviewed at least six monthly. Manual handling, risk assessments and positive handling plans are also completed where it is deemed appropriate.

p.6

Helping children make a positive contribution

Children and young people's statutory reviews are held at the required intervals together with other relevant meetings. Very few children and young people attend these unless there is a purposeful reason for this. However, all relevant parties are invited to attend the statutory reviews.

p.7

Helping children make a positive contribution

Contact between the children and young people and their parents/carers is actively promoted by the home.

p.7

Helping children make a positive contribution

Good communication exists between the staff and children and young people's parents/carers and respective social workers to ensure that they are kept informed and up to date about any matters. Children and young people, with the support of staff, can maintain contact with their parents/carers by using the home's cordless phone.

p.7

Helping children make a positive contribution

Children and young people's meetings are held within the home to obtain their views about the various aspects of care they receive. Staff use a range of communication methods for this purpose which includes Makaton, picture exchange communication systems, pictures and photos.

p.7

Helping children make a positive contribution

Children and young people live in an environment where they enjoy positive and relaxed relationships with staff who are themselves very committed to providing a high level of care. Staff carry out their duties in a caring, respectful and attentive manner. Children and young people were observed to be relaxed and at ease in the company of staff and within their environment.

p.7

Achieving economic wellbeing

The provision is satisfactory. The home’s location, design and size are in keeping with its stated purpose and function. It is divided into two units. Children and young people live in a caring environment which is maintained to a good standard, being clean, tidy and comfortable. The home is also well furnished and decorated. Children and young people are provided with their own bedrooms and the home continues to provide good communal space to meet their individual and collective needs. In addition the home also provides sufficient bath and toilet facilities with aids and adaptations, including specialist bathing facilities, to meet the specific needs of the children and young people accommodated.

p.7

Achieving economic wellbeing

A continuing deficiency relates to the heating and hot water arrangements provided to the home. These services are provided by a central boiler house. As two of the service providers have now relocated, a new boiler house was due to be completed for the home. Inexplicably, this was put on hold by the authority, despite being an Ofsted action at the last two inspections. As a result of it being raised by Ofsted again at this inspection, this decision has now been reversed, although major works will not be completed until mid August 2010. The home has now established a monitoring system to identify any deficiencies in the heating and hot water 7 of 9 Inspection Report: SC031504 provided so that it can be maintained at a suitable level for the comfort of children and young people accommodated.

p.7

Organisation

The organisation is good. The promotion of equality and diversity is good. Equality and diversity are promoted well in all aspects of the service. Policies and procedures relating to equal opportunities are well established. The home promotes diversity and tolerance taking into account the individual needs of children and young people.

p.8

Organisation

A clear Statement of Purpose is established which describes the level of service children and young people can expect to receive and how they will be cared for. Copies of this document are readily available on request to all interested parties. The home has also produced a user friendly young people's guide in a combination of pictures, symbols and written form. A copy of this document is provided to all children and young people as part of their introductory visits and provides them with information about the home.

p.8

Organisation

Children and young people are looked after by a staff team who are themselves properly managed and supported in safeguarding and promoting the welfare of the children and young people. Daily handover meetings and regular staff meetings are established which ensure that staff are kept up to date with regard to any issues relating to children and young people and the home. However, not all staff are receiving formal one to one supervision at the recommended intervals.

p.8

Organisation

Children and young people are looked after by a staff team who are trained to meet their needs. New staff are provided with an induction programme when they commence employment. Staff are supported and encouraged to increase their knowledge and expertise through attendance at appropriate training courses. However, staff did acknowledge that a number of courses are cancelled which they find frustrating. The minimum ratio of 80% of the staff team have now achieved the National Vocational Qualification at level 3 in the Care of Children and Young People.

p.8

Organisation

The home is committed to providing sufficient staff on duty to meet the individual and collective needs of the children and young people. This is achieved by normally providing between three and four members of staff on duty within each unit throughout the waking day. Two members of waking night staff are on duty with one member of staff sleeping-in each night. Regular casual or existing staff are used to cover any staff shortfall. The staffing arrangements for evening and morning routines have been reviewed to improve the continuity and consistency that children and young people receive in line with best practice. However, although this is achieved during school holidays and at weekends, it is more difficult during term time.

p.8

Organisation

The authority ensures that the care and welfare of the children and young people is continually monitored. This is achieved by monthly unannounced monitoring visits being undertaken by the home's team manager within the authority. Reports are produced outlining these visits and any action needed to improve the outcomes for children and young people. The home's managers are supported by a deputy and four seniors which enable them to effectively monitor the day-to-day care provided to children and young people. 8 of 9 Inspection Report: SC031504 The home is usually managed by two Registered Managers as a job share who are suitably qualified and experienced. One manager has been seconded within the authority and appropriate arrangements have been put in place to cover this. Effective leadership is exercised to ensure that the home is well organised, managed and staffed so that the children and young people

p.8

Organisation

receive stability of care. The managers also demonstrate a good knowledge and understanding of the home and the needs of staff, children and young people.

p.9

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.

p.9

Due date Action Standard

19 April 2010 ensure that a written record is made of any complaint, the action taken and the outcome of the investigation (Regulation 24(5)) 1 April 2010 ensure, that at all times, all parts of the home used by the children and young people are consistently and adequately heated and sufficient quantities of hot water are provided. (Regulation 31(2)(a)&(4)(a))

p.9

Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure that a full written record is maintained of all sanctions and restraints (NMS 22.10) • ensure that all staff working in the home receive at least one to one supervision from a senior member of staff each month and new staff fortnightly during the first six months of their employment (NMS 28.2) • ensure that every effort is made so that staff working with children and young people in the evenings are also involved in their morning routine in order that they receive continuity and consistency of care. (NMS 30.3) 9 of 9 Inspection Report: SC031504

p.9