Children's Home run by Isle of Wight Council in Isle of Wight

SC395944 Unique reference number 15 December 2009 Inspection date Lynda Mosling 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: SC395944

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Brief description of the service

This children's home is a purpose built respite facility located in a semi-rural area close to the nearest town. It is owned by the local council. It is accessible to many of the town's facilities and major transport links.

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Brief description of the service

The accommodation is specifically designed to meet the needs of young people with multiple disabilities, it is equipped with appropriate lifting equipment including overhead hoists. All young people are provided with their own rooms. The home is on one level and has a safe enclosed garden accessible to the young people.

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Brief description of the service

It is registered to take up to 6 young people with learning difficulties and/or physical disabilities between the ages of 8 years and 17years.

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Summary

This unannounced inspection assessed the key national minimum standards for children's homes. Although the home has been providing respite care to young people for a number of years it was first registered in 2009 and this is the first inspection since registration. Three young people were in placement on the day of the inspection and were observed as part of the process.

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Summary

The home provides good care, with some outstanding elements, to young people using the service. Care is provided by a committed care team who demonstrate warm relationships with the young people. They have an excellent understanding of young people's needs and use a range of communication strategies to ensure they know how young people are feeling.

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Summary

Clear assessment of needs include detailed health information which is used to deliver competent care, overseen by the care staff with nursing qualifications. There is close liaison with the two local schools attended by the young people and all achievements are celebrated.

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Summary

As a respite service the parents or main carers are very involved in the planning of placements and the service is described as a brilliant support to the whole family. Young people were observed to be settled and happy during the inspection and were enjoying a range of different activities.

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Summary

Only one action relating to record keeping is made as a result of this inspection. 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 the home was newly registered in July 2009 this is the first key inspection.

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Helping children to be healthy

The provision is good. The needs and preferences of each young person are well known to the care and catering staff. This ensures that appropriate foods are offered at each meal. Staff provide sensitive support to those who require help with feeding but encourage young people to be as independent as 4 of 9 Inspection Report: SC395944 possible. Young people are involved in choosing the daily menu and there is good interaction with the staff throughout mealtimes.

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Helping children to be healthy

The health assessments for each young person are thorough and include reports from a variety of specialists. The health care plan is clearly recorded and is delivered with the support of medical colleagues. Two of the care staff are registered nurses and this enhances staff confidence when dealing with complex medical needs. There is good liaison with the local hospital and ambulance service and records show appropriate action is taken in the event of a medical emergency. As this is a respite service parents are very involved in the health care of their children and are kept informed of all issues relating to their health.

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Helping children to be healthy

Young people's medication needs are clearly recorded and there are good, safe arrangements for the administration of drugs. Staff receive training in any medical intervention required and are confident that they can meet the needs of the young people they care for. Good communication with parents and the local schools ensure that any illness or unusual behaviour is passed on so that the young person can be monitored. There is useful information available to staff relating to the medical diagnosis of each young person to help the staff understand and deal with the implications for their care.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people's privacy is respected by the staff who ensure that all personal care is undertaken in private. Staff are sensitive to young people's feelings and respect their desire to spend time away from others when they communicate this. All bedrooms are single and are available for use by the young people at any time during their visit. Where young people are unable to tolerate curtains in their rooms shutters have been provided to protect their privacy.

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Protecting children from harm or neglect and helping them stay safe

There is a clear complaints procedure that includes an independent element. There have been no formal complaints made since registration. Parents confirm that any issues of concern are dealt with quickly and professionally. The recent development of child friendly feedback forms ensures that the manager and staff are aware of the young people's views about their care. Staff are quick to pick up any distress or anxiety felt by the young people and work closely with them to identify, and resolve, the cause.

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Protecting children from harm or neglect and helping them stay safe

Staff confirm that they have received training in child protection and understand their responsibility to keep the young people in their care safe. There are very thorough child protection procedures that give step by step guidance to staff in the event of concerns or allegations. The home is careful to use body maps to record any bruise or mark seen on young people and instigates child protection enquiries appropriately. There is good understanding of the need to protect staff as well as young people.

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Protecting children from harm or neglect and helping them stay safe

The missing persons procedures are clear and thorough. They have not been used since registration as there have been no incidents of young people going missing. The individual files include a helpful identification sheet, including photograph, to use in the event of such an incident. Risk assessments clearly highlight the likelihood of young people going missing but as all young people are accompanied when outside of the home this has not been an issue. 5 of 9 Inspection Report: SC395944 Care plans indicate possible challenging behaviour and how to manage it. Each young person has an individual behaviour management plan that identifies their preferred method of control. Restraint is very rarely used but is clearly recorded and undertaken according to the agreed policy and procedure. Staff have close and warm relationships with the young people and know what their gestures and signs mean. They respond well to young people and advocate on their

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Protecting children from harm or neglect and helping them stay safe

behalf. The manager uses individual staff relationships with the young people to good advantage by ensuring the appropriate staff are on shift for particular young people. However, all staff are helped to develop their skills across the whole group of young people using the service to ensure sensitive care is consistently given.

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Protecting children from harm or neglect and helping them stay safe

The home is purpose built and offers good, safe accommodation. Entrances and exits are on a buzzer system and all visitors are required to identify themselves. There are very clear procedures covering contractors and maintenance visits. The fire records are up to date and include records of staff training and evacuation drills. The manager ensures that the building and grounds are kept in good order and are made safe for the young people. There are efficient systems in place to ensure environmental, and health and safety checks, are routinely carried out.

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Protecting children from harm or neglect and helping them stay safe

The recruitment process is led by the human resources section of the council and is designed to keep young people safe. The manager ensures all relevant checks are satisfactory prior to new staff having contact with young people. A new member of staff confirmed that the recruitment process is rigorous and thorough and includes a comprehensive induction programme. The recruitment process includes representation from parent groups and other disciplines.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Individual support to young people is described as "superb" and "brilliant" by social workers and parents. This respite care service is seen as excellent support to the whole family. Staff display a remarkable knowledge of each young person's needs and interact with them with pleasure and sensitivity. Communication preferences are respected and staff were observed to give their undivided attention to the young people they were caring for. Staff clearly allow the young person to take the lead in what they choose to do and are careful to ascertain their views when planning the activities. The care plans identify individual need, including religion, identity and culture. All young people are respected in their own right and helped to reach their potential.

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Helping children achieve well and enjoy what they do

Whilst this is a respite service providing short term breaks to young people the home works very closely with the two local schools attended by the young people. The staff usually provide the transport to and from the schools at the start and end of the overnight stays and this gives them an excellent opportunity to share information about the young person. Education assessments are kept on file and staff are involved in the educational reviews. Whilst the communication and behaviour strategies are shared with the schools to provide consistency, the home is clear that the respite placements provided to the young people aim to provide enjoyment and relaxation as well as ongoing learning. All achievements are well celebrated and photographs of young people gaining awards are displayed around the home. Each young person has an independence plan that identifies specific targets for learning life skills appropriate

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Helping children achieve well and enjoy what they do

to their understanding and ability. It is clear that many of the young people have developed new skills with the help of the staff at the home. 6 of 9 Inspection Report: SC395944 Young people's interests and preferences are used to plan activities and the staff provide individual support to ensure there is choice for each young person. Young people were observed to be asked about the way they want to spend their time and staff organise the shift to take account of this. Favourite pastimes are supported such as walking, foot massage and repetitive play. Young people are encouraged to socialise with others but can also choose to spend time alone. There is an extremely large range of activities on offer and the home are involved in local community events such as pantomimes, shows and festivals. No assumptions are made about the young people's ability to enjoy special occasions and events and each is given the

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Helping children achieve well and enjoy what they do

opportunity to try new experiences, with their parents permission. Young people were observed to enjoy their time in the home and to show a range of emotions that were understood and sensitively responded to by the staff.

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Helping children make a positive contribution

The provision is outstanding. Young people's needs are comprehensively assessed at the point of referral and an interagency group of professionals considers the best resource for the individual. This ensures placements at the home are appropriate. The manager is very careful to ensure that the placements fall within the registration category whilst being flexible and helpful in responding to young people's needs.

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Helping children make a positive contribution

Placements are reviewed regularly and include the views of a range of involved professionals as well as the young person and family. There are excellent progress reports under each area of care such as health, safety, enjoyment, social behaviour and education. Records are updated accordingly and the care plan changed where necessary. Some of the staff have worked with the young people for many years and are proud of the progress they have made during this time.

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Helping children make a positive contribution

As a respite service parents of the young people are very involved in the plans for the care offered. They are kept informed of any issues concerning their children and are recognised as the main carers. Parents are seen as experts regarding their children's needs and are valued and respected. Parents say they receive exceptional support from the staff and have confidence in the consistent and outstanding care. Young people are rarely out of contact with their parents for more than a few days.

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Helping children make a positive contribution

The arrangements for young people moving into the home are developed in response to individual need and are sensitive to the feelings of the parents and the young person. Gradual introduction at the young person's pace is arranged to lessen anxiety. Many of the young people will recognise other young people from their school and this helps them feel confident and relaxed during introduction. Excellent use of existing relationships with staff also enable young people to settle quickly. The preparation of rooms for each placement is very well planned, including the provision of the young person's favourite games, posters and DVD's. Transitions to other resources, when they happen, are very well planned.

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Helping children make a positive contribution

The communication between staff and young people was seen to be exceptionally good. Staff give their undivided attention to the young people they are looking after and use the agreed communication systems to ensure they understand young people's views. They are patient in their dealings with young people and persevere until they are sure that the young person knows what is being asked of them. Where staff remain unsure of what a young person is trying to 7 of 9 Inspection Report: SC395944 say they will get assistance from other colleagues to interpret this. The newly introduced system of using symbols and pictures to gain feedback from young people about their care provides additional evidence of the importance given to their views.

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Achieving economic wellbeing

The provision is good. The young people are helped to develop independence skills but most are unlikely to lead a fully independent life. The staff are sensitive to age appropriate activities and encourage young people to develop appropriate interests. There are few local resources for young people over the age of 18 years to move onto in terms of respite care, but where such arrangements can be made the staff are involved in developing sensitive and thorough transition plans.

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Achieving economic wellbeing

The home is domestic in style and has been purpose built to provide attractive and spacious accommodation for the young people. The home is on one level and is easy to access for wheelchair users. There is a good range of equipment, including hoists, to provide appropriate care for young people with physical disabilities. Each young person placed has their own room for the period of their stay. The home is well maintained and is situated in an area close to plenty of open spaces and community amenities. A part of the home, originally intended for longer term placements, remains unused and separate from the respite facility. Whilst this does not impact negatively on the running of the respite service some parents and staff feel the building is underused, particularly as there is a waiting list for respite placements.

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Organisation

The organisation is good. The statement of purpose is kept updated and gives an accurate picture of the service on offer. Additionally there is a guide for young people written with symbols and pictures to describe the service. Young people are able to visit the home and meet staff prior to any planned placement.

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Organisation

The promotion of equality and diversity is good. The home provides very well for the individual needs of young people including religious, identity and cultural considerations. Staff receive training in diversity and equality and act as advocates for the young people they care for. They challenge any discrimination and help the young people access all of the services and opportunities provided locally. Young people are celebrated and enjoyed as individuals.

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Organisation

Staff are competent and confident and have many years of combined experience of working with young people with complex needs. Some staff have known the young people they care for since an early age and show great commitment to their care. Staff training is good and includes comprehensive induction as well as refresher training to keep them up to date with current practice issues. Over 80% of staff have gained the national vocational qualification at level 3 or higher.

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Organisation

The staffing ratio is worked out at each shift according to the needs of the individual young people cared for. There are sufficient staff to meet the young people's individual and group needs. The manager has the authority to request additional staff when the needs of young people or circumstances suggest this. 8 of 9 Inspection Report: SC395944 Supervision of staff is undertaken both formally and informally and staff feel supported by the manager and senior staff. Meetings are regular and include staff from across all shifts. The staff work well together and feel valued and proud of the work that they do. They demonstrate an impressive knowledge of the young people they care for. The manager is seen as a strong leader and is respected by the staff team.

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Organisation

Internal monitoring arrangements are very good and ensure all of the standards and regulations are met. There is clear evidence of recommendations being acted upon and the manager has been proactive in ensuring that the home was registered and meets all the requirements. She feels supported in this by the present management arrangements.

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Organisation

Records are generally a strength within the home, although the register of placements did not show all of the necessary details. Staff are able to access the information required to give good care to the young people and key workers update this information regularly. The records are clear, comprehensive and well set out. Staff were seen to be using them effectively to inform their practice.

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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

29 January 2010 ensure a register is kept containing all the information required about each young person accommodated, as set out in schedule 4. (Regulation 29(1))

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Recommendations

There are no recommendations. 9 of 9 Inspection Report: SC395944

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