Children's Home run by Brighton and Hove City Council in Brighton and Hove

SC044880 Unique reference number 10 November 2009 Inspection date Paul Taylor Inspector Key Type of Inspection

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3 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: SC044880

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Brief description of the service

The service has two registered managers. Young people with a learning difficulty stay at this home. It is divided into two separate sections and has a total of eight single bedrooms in all. Up to five young people can be accommodated for residential short breaks in one section of the unit and a further three young people in the other section of the unit; two of the young people in this section are permanent residents. There are communal areas which include lounges, kitchen/dining rooms, a sensory room, a soft play room and a large garden, which has numerous pieces of play equipment.

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Summary

At this unannounced inspection all the key standards were assessed. Young people receive very good meal provision which meets their personal choices. The health care needs of young people are met to an excellent standard and their specific needs are addressed in an individualised and focused fashion. Robust procedures and policies are in place to protect young people, this is underpinned by regular training and excellent staff awareness and sensitivity. The individual needs of young people are met in an excellent manner with rigorous care planning engaging parents, carers and, wherever possible, young people themselves. Reviews of care occur routinely with all staff contributing to ensure the best possible outcomes for the young people. Young people enjoy the benefits of a relaxed and comfortable home. The setting continues to be managed extremely well with staff being committed and caring.

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Summary

One recommendation was made as a result of this inspection relating to staff qualifications. 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 recommendations or actions made at the last inspection. The home continues to offer an outstanding level of care to the young people.

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Helping children to be healthy

The provision is outstanding. The staff know each young person's dietary needs and preferences. How food needs to be prepared and served for the young people bearing in mind their learning difficulties, is also known to the staff team. The young people are offered a varied and healthy diet. The staff work hard to ensure that they are given the opportunity to try new foods if it is felt that the young person can accomplish this and if their parents or guardians agree. Mealtimes are carefully planned events which are sociable and relaxed.

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Helping children to be healthy

Health needs of the young people are very well met. Appointments with health professionals are arranged and specialist input is gained to ensure that the young people's emotional and physical health is promoted. The complex health needs of the young people are recorded in detail in their health care plans, which are regularly updated and audited to ensure their accuracy. All young people have written consent from their parent or guardian with regards to the administration of medication or first aid. 4 of 9 Inspection Report: SC044880 The home has a rigorous system for ensuring that the administration of medication is closely monitored and regularly audited. Medication administration is checked three times a day. Staff attend training on the administration and storage of medication.

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Helping children to be healthy

The health of the young people both physically and emotionally is valued and promoted to an excellent standard.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. Privacy is respected by the staff team and sensitive information is stored securely. Clear guidelines are in place for the staff to follow to ensure that there is a correct balance in maintaining young people's privacy and safety whilst they are unsupervised, for example, when in their rooms.

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Protecting children from harm or neglect and helping them stay safe

Information on how to complain is made available to the young people in their handbook. The learning difficulties of the young people means that they may not have the ability to understand the concept of what constitutes a complaint. The staff use their knowledge of each young person to ascertain from their behaviour and vocalisation whether a young person is unhappy about something. Staff receive training in complaints and whistle blowing as part of their induction process. Complaints are addressed promptly and the results of any complaints thoroughly recorded, including whether the complaint was founded and whether the complainant was satisfied by the outcome.

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Protecting children from harm or neglect and helping them stay safe

All members of staff receive child protection training and are up-to-date with child protection procedures. Additionally they have access to local safeguarding procedures and the organisation's child protection policy. They are clear as to their obligations in the event that they have concerns about a young person's well-being. Detailed records are maintained on any child protection or welfare concerns and how they have been pursued and resolved. The home's approach with regards to ensuring that any child protection matters are addressed is rigorous and involves close liaison with all agencies and parents.

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Protecting children from harm or neglect and helping them stay safe

There is a policy and guidance for the staff to follow with regards to bullying. The cognitive disabilities of the young people means that they do not necessarily understand the concept of bullying. The staff who work in the home are aware of the group dynamics and what triggers can lead to behaviour which may cause conflict between the young people. Close supervision and support of the young people ensures that incidents are kept to a minimum.

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Protecting children from harm or neglect and helping them stay safe

The staff are very aware of the young people's extreme vulnerability in the event that they go missing. Therefore, the need to closely supervise them to ensure their safety is embedded in the practice of the home. There is very clear guidance and an emergency protocol for staff to follow if a young person is missing. There have been no incidents where young people have gone missing from the home or whilst on supervised outings.

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Protecting children from harm or neglect and helping them stay safe

The behavioural needs of the young people living at the home are responded to in an individual, well planned and sensitive manner. All young people have detailed behaviour management plans, individual to their particular issues, which are tailored to address their personal anxieties, fears and frustrations. Staff respond appropriately to challenging and aggressive behaviour in a calm and measured fashion, clearly understanding the behaviour of the young people in their care. 5 of 9 Inspection Report: SC044880 Where sanctions are imposed, they are clearly recorded and endorsed by the manager. If an incident requiring physical intervention occurs, a record is kept of the incident and this is also checked by senior members of staff and the managers to ensure that the use of physical intervention was appropriate. Each young person has an agreed physical intervention risk assessment (PIRA) completed and endorsed by parents and professionals. This document sets

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Protecting children from harm or neglect and helping them stay safe

out the measures to be used in the event that a young person needs to be physically controlled. All members of staff are trained in the method of restraint used in the home.

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Protecting children from harm or neglect and helping them stay safe

Detailed risk assessments are made with regards to the premises and activities in which the young people partake. They are regularly reviewed and updated. Additionally, individual risk assessments are completed on the young people with regards to their behaviour and potential vulnerability in certain situations, such as going missing, travelling in cars, swimming, bathing, eating, cooking and playing in the garden or ball pit.

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Protecting children from harm or neglect and helping them stay safe

Regular checks of the premises and safety equipment, such as fire alarms, are carried out. External professionals also underpin these checks with their own checks and tests. Fire drills also occur on a regular basis.

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Protecting children from harm or neglect and helping them stay safe

All visitors to the site are required to report to reception. The recruitment of staff is subject to a vigorous process and records, such as Criminal Records Bureau checks and references are carried out prior to employment.

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Protecting children from harm or neglect and helping them stay safe

The systems operated by the home and the alertness and commitment of the staff team ensures that the young people's safety and well-being is protected and promoted to an excellent standard.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Individual support to the young people is carefully and sensitively planned. Each young person's needs are known and each young person's behaviour support plan specifies in detail what support they need. External specialist input is accessed by the staff team if necessary. The care plans clearly highlight the particular needs of each young person with specific matters or complex care needs being comprehensively met.

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Helping children achieve well and enjoy what they do

It was clear that the communication needs of young people are of paramount importance in meeting and understanding their needs. Staff have a keen appreciation of how each young person expresses their individual wishes and feelings and respond to them accordingly. The young people are not all able to verbalise their needs, however, staff are acutely aware of the subtlety and manner of communication preferred by the young person in question. The use of symbols, pictures and augmented communication is encouraged and the young people are supported and guided to utilise and learn the most appropriate format for them. Examples of communication used are Makaton and pictures systems.

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Helping children achieve well and enjoy what they do

Each young person in the home has a personal education plan (PEP). These are up to date and include strategies and plans to help the young people develop their education and life skills. Staff provide excellent levels of support to the young people to enable them to attend their educational settings. Good and regular communication is achieved with the young people's 6 of 9 Inspection Report: SC044880 schools. It is clear that education is highly valued by the staff team and a lot of effort is made to assist the young people in experiencing school as a positive part of their lives.

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Helping children achieve well and enjoy what they do

Young people are given considerable support and encouragement to engage in activities. Activities can include walks, bowling, swimming and a summer camp. If young people find groups difficult then individual sessions are planned. The staff work very hard and inventively to ensure that the young people can experience positive activities in the community. The safety of activities are underpinned by a rigorous risk assessment process.

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Helping children make a positive contribution

The provision is outstanding. A thorough approach towards care planning, assessment and review ensures young people have their particular needs suitably considered and planned for. Young people access services at the home following a planned process which includes the gathering and assessment of information regarding their physical, medical, social and emotional care needs. Such needs are comprehensively assessed and incorporated into individualised plans of care. Each plan clearly describes how staff should care for each young person with a key focus on their communication needs, abilities and often complex health needs.

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Helping children make a positive contribution

Regular reviews of care ensure care plans match the current needs of each young person in an individualised fashion. The whole staff team contribute to routine meetings where any change to each young persons circumstance, behaviour or emotional well being are considered fully. Excellent reviews of care focus on the progress of the respective young person against their care plan. Detailed reports are provided for statutory reviews.

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Helping children make a positive contribution

Contact arrangements are made clear in the young people's care plans. Records of contact between parents and professionals and the home are maintained. Visitors are welcome in the home and there is ample space for visits to take place in privacy. It is recognised that most of the young people are in the home for short periods of respite care and that during their stays they will not have visits from their carers.

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Helping children make a positive contribution

Wherever possible, all placements are planned in advance, although robust assessment protocols and procedures ensure young people can be accommodated at short notice. Young people are only admitted into the home once a full and comprehensive assessment of their care needs has been completed. Admissions are carefully considered and the process is planned commensurate with each young person's ability to deal with the transition.

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Helping children make a positive contribution

Members of staff know how each young person communicates. Due to their learning disabilities the young people develop idiosyncratic ways of communication and these are recognised by the staff working with them. Overall the staff encourage the young people to have a voice in the running of the home, especially by responding to their likes and preferences around food and activities. As mentioned earlier, few of the young people are able to verbalise their thoughts and feelings and so rely on augmented communication methods. The staff develop their communication skills by practising relevant techiques. They develop their knowledge of the young people by being with them and understanding how they use behaviour as a form of communication. The views of the young people are gained from parents, professionals and from the young people themselves and this enables the staff to involve them in how they live their lives and express their feelings.

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Helping children make a positive contribution

7 of 9 Inspection Report: SC044880 The interactions between the staff and the young people are relaxed and warm. The young people are seen to seek the members of staff for company, comfort and reassurance. The staff are committed to making the young people feel relaxed and at ease during their time in the home.

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Achieving economic wellbeing

The provision is outstanding. The staff follow a programme which is designed to assist young people to prepare for transition to adult placements. The staff knowledge of the young people's strengths, weaknesses and anxieties ensures that the program is delivered at a pace which is commensurate with their abilities. This process is sensitively planned and offers an excellent level of support to the young people, and their parents and involves close liaison with future placements and relevant agencies.

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Achieving economic wellbeing

The home is well maintained, comfortable, tidy and safe. Each young person is afforded the opportunity to personalise their own rooms with posters and pictures, additionally they can choose the colour of the décor should they wish. Children receiving respite care have their rooms personalised with familiar pictures and objects. Staff carry out regular checks on the environment to identify any maintenance issues. The home is comfortable, bright, cheerful and child-friendly. Excellent facilities such as a sensory room, play area with ball pit and a large amount indoor space ensure that the young people have a welcoming and fun environment which offers space and stimulation. A large garden provides young people with outdoor space, play equipment and a trampoline.

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Organisation

The organisation is outstanding. The home's Statement of Purpose is up to date and accurately reflects what the home intends to achieve. There is a children's handbook, which explains in pictorial and symbolic form what it is like to live in the home. These documents are checked regularly to ensure that they are up to date and accurate.

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Organisation

All members of staff receive regular supervision and appraisals. Additionally there are regular, well attended team meetings to discuss the running of the home and the young people's behaviour and progress. Policies and procedures, which are regularly reviewed by the manager and senior members of staff in the organisation, are readily available.

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Organisation

The training offered to the staff team is varied and regular. There is a rolling training program for National Vocational Qualification (NVQ) at level 3 in caring for children and young people. The home does not yet have a ratio of 80 per cent of staff who have achieved this qualification. There is a thorough induction plan which ensures that new members of staff are prepared for working in the home. The committed staff team has enough experience, qualifications and skills to offer excellent levels of support to the young people.

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Organisation

Practice is monitored by external managers who carries out regular visits to assess the standard of care provided. Reports written as a result of these visits are thorough and detailed and indicate which areas of the home need improvement. The manager in turn also regularly checks all the areas outlined in Schedule 6, such as restraint and sanctions, medication, accidents and admissions and discharges. The overall monitoring of records is detailed, well planned and of an excellent standard. 8 of 9 Inspection Report: SC044880 The home has two managers who share their role. They work very well and efficiently together and achieve high standards of monitoring, guidance and support for the staff team.

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Organisation

The young people's care plans are very well organised, regularly reviewed and updated and are subject to thorough checks by the key workers, supervisory staff and manager. All information is securely stored.

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Organisation

The promotion of equality and diversity is outstanding. Each young person's individual needs are known and met by the staff team. The nature of the young people who live in the home means that each individual's needs and idiosyncrasies have to be carefully catered for. Diversity and difference is seen as an opportunity to learn from each other and to be enjoyed and celebrated.

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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

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • continue to work towards ensuring that at least 80% of the staff team achieve National Vocational Qualification Level 3 in Caring for Children and Young People. (NMS 29). 9 of 9 Inspection Report: SC044880

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