Children's Home run by West Sussex County Council in West Sussex

SC067753 Unique reference number 11 January 2010 Inspection date Kevin Whatley Inspector Key Type of Inspection

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21 August 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: SC067753

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Brief description of the service

The setting is predominantly a respite service for children and young people with both physical and learning disabilities, although longer term placements are catered for. The home is registered for a maximum of 16 young people.

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Brief description of the service

The home is a purpose-built building which offers the young people a wide variety of facilities. The spacious accommodation includes single bedrooms, communal lounges with dining space, soft play areas and a well-equipped sensory room. There are several large bathrooms which provide enough space and the facilities for those requiring personal care or who are physically disabled. Ceiling tracking for hoisting is available in part of the building, ensuring those who are less mobile are included and involved in activities. The home is close to the local town and countryside which can offer the children and young people a wide range of activities based in the community.

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Summary

This key inspection was unannounced and took place on a weekday. Three recommendations were made as a result of this inspection. Young people receive good meal provision which meets their personal choices and special dietary needs. The health care needs of young people are met well, with specialist training given to staff in the event of emergency situations occurring. Robust procedures and policies are in place to protect young people from the risks of harm with staff receiving very good training in safeguarding matters. The individual needs of young people are met in an excellent manner with young people having their particular needs responded to in a comprehensive and sensitive fashion. Sound care planning and review procedures ensure young people have their needs assessed at the point of admission and at regular intervals thereafter. Young people benefit from living in a well maintained and comfortable home. The

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Summary

setting is managed extremely well with committed and caring staff providing care and support in a manner which meets the particular needs of young people. 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

Two actions were made at the last inspection. One action related to the locking of doors as a planned response to the behaviour management of a young person, while the second action concerned the need to cover some exposed hot water pipes. The locking of doors is no longer used as part of any behaviour management plan at the setting. The particularly challenging behaviours of young people are addressed in an intensive fashion with expert advice being applied alongside experienced and consistent staffing arrangements. The exposed hot water pipes have now been covered over ensuring a safe bathroom environment.

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Improvements since the last inspection

Five recommendations were made at the last inspection. One recommendation related to staff taking paracetamol for themselves from the settings medication stock and failing to record it, while a second recommendation noted that all staff files needed to contain photographic confirmation of their identities. A further recommendation stated that young people should be involved when fire evacuations are carried out, while another suggested that a more formalised process be implemented for gaining the views and wishes of young people with 4 of 9 Inspection Report: SC067753 regard to the running of the home. The final recommendation concerned the need to keep care plans and behaviour management logs up to date and accurate. Paracetamol is no longer stored at the setting and therefore this has considerably reduced the risk of staff making errors on medicine stock records. A process has almost been completed whereby all staff have been given,

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Improvements since the last inspection

or are due to be given, new photographic identification badges. A review of how fire evacuation drills are carried out has been completed and one is due to take place which will occur while young people are resident. The manner in which the views and opinions of young people are gained and evidenced is underway with the intention of implementing a tangible and meaningful process. All care and behaviour management plans seen on this occasion were found to be accurate and up to date.

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Helping children to be healthy

The provision is good. Young people receive suitable meal provision with balanced and nutritious meals being made available daily. The special dietary needs of young people are considered when menus are planned. The types and amounts of foods eaten by young people are appropriately monitored. Wherever possible young people are encouraged to eat healthily, on occasion this has included involved them in helping to prepare home made meals.

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Helping children to be healthy

The health care needs of young people are met well. Robust care planning procedures ensure the physical, medical and emotional needs of each young person are considered in full. Health care plans are clear and obvious highlighting all relevant issues including immunisation records and past and current medical histories. Being a predominantly respite service most young people have their routine medical matters facilitated by their parents. Those young people on longer term placements are registered with local GP's and are assisted to attend all routine medical appointments including the dentist or opticians. Close working relationships with external health care professionals, such as the looked after children's nurse and speech and language therapist ensure that any specialist input is provided. Staff are suitably trained to meet specific medical situations such as when young people have seizures with clear protocols in place to

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Helping children to be healthy

Young people are encouraged to lead as healthy a lifestyle as is physically possible. Staff are positive in engaging young people in activities with regular trips to activity centres and swimming pools.

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Helping children to be healthy

The storage and administration of medicines is generally good with young people having their medication stored and given to them safely. Consents for the giving of medication, first aid and emergency treatment are in place with only staff, who are trained to do so, dispensing medicines. Records of medication kept at the home were for the most part accurate. However one homely medication had not being recorded in the stock control log, while the actual stock record of such medication is not updated when these are given; stocks of homely medicines are checked every two months.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. All confidential information regarding young people is stored securely in the office. 5 of 9 Inspection Report: SC067753 Information concerning how to make a complaint is made available in formats which young people can understand. Parents and carers are provided with suitable details of how to complain and of alternative advocacy services. When complaints are made they are dealt with swiftly and appropriately. No complaints have been received by Ofsted since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

A robust approach toward child protection ensures young people are as safe as can be expected. Staff receive training in safeguarding and clearly have a sound understanding of all key child protection matters and protocols. All policies and procedures are produced in line with current local and national safeguarding legislation and practices.

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Protecting children from harm or neglect and helping them stay safe

A rigorous recruitment process ensures no members of staff work at the home until all necessary checks and references have been confirmed.

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Protecting children from harm or neglect and helping them stay safe

Staff are very mindful of the need to address issues amongst young people which may be seen as bullying type behaviours. The levels of supervision by staff significantly reduces the risk of young people being subject to such behaviour with no obvious concerns identified.

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Protecting children from harm or neglect and helping them stay safe

The challenging and risky behaviours of young people are considered and planned for comprehensively. All young people have individualised behaviour management plans which focus on their particular issues such as violence or aggression. Clear risk assessments are completed which highlight the risk young people may be to themselves or others with clear plans and strategies in place to reduce any identified concerns. All strategies implemented consider the manner in which young people communicate distress, anger or frustration with staff displaying a sound understanding as to how each young person expresses their feelings.

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Protecting children from harm or neglect and helping them stay safe

The level of physical interventions at the setting is relatively low. Staff are keen to limit the need to intervene physically and only do so when absolutely necessary. All staff are trained in the model of physical intervention sanctioned by the organisation. Those young people who are known to have particular violent or aggressive behaviours have intensive programmes implemented with consistent and experienced staff members providing a majority of their day to day care. Where necessary advice and guidance is sought from specialist child care experts with regular reviews monitoring the progress of such focused behaviour management programmes. Current behaviour management plans have helped to reduce a young person's aggressive behaviour and thus allow them to integrate more readily with other young people.

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Protecting children from harm or neglect and helping them stay safe

The health and safety of all those who live and work at the setting is taken seriously. All required servicing, tests and checks are undertaken with regard to fire fighting, gas and electrical equipment. Regular fire alarm and emergency lighting tests are completed with routine fire drills taking place within required timescales. No fire evacuation drills have involved young people since the last inspection, though one is planned to take place shortly.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people have their particular needs met in an excellent fashion with consistently high levels of individual support being provided. Key working is a fundamental aspect of the service with the particular needs of young people being of paramount importance. Irrespective of the number of times any young person stays at the setting, staff provide a consistent and planned level of care which matches the needs of each young person. 6 of 9 Inspection Report: SC067753 Staff display considerable understanding of each young person's physical, medical and social care needs with a notable focus on how they communicate their needs, wishes and feelings. Routine child focus meetings review the individual progress of young people with comprehensive care planning responding to changing needs and circumstance. It is clear staff understand the needs of young people in their care very well, being able to provide support and care in a

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Helping children achieve well and enjoy what they do

Each young person has a personal education plan that clearly defines the type of programme they are receiving. Close liaison with parents and schools and colleges ensures all parties are aware of each young person's progress with regard to their particular education provision. A majority of young people only access the service on an occasional basis, nevertheless good communication is maintained including the use of communication books with staff clearly supporting and encouraging young people in their learning.

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Helping children achieve well and enjoy what they do

The day-to-day running of the home encourages the engagement of young people in their personal choices and activities. This can include visiting local places of interest, shops and activity outings such as swimming trips and attending leisure centres geared to meeting the complex needs of young people accessing the service. Wherever possible the individual interests of young people are supported and facilitated. Good opportunities are provided for daily activities and outings and staff encourage young people to participate in the things they enjoy. The recent Christmas holidays included visits to pantomimes.

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Helping children make a positive contribution

The provision is good. Comprehensive admission and care planning procedures ensure no young person is admitted to the home without first being assessed as suitable for the setting. Wherever possible the acting manager, or other senior members of staff within the organisation, visit young people before they move in as part of the overall assessment process. All young people have their physical, social and emotional needs assessed and planned for. Group dynamics are also considered to ensure, as best as possible, that new young people mix appropriately with existing placements. The individual needs of young people are assessed in detail being incorporated into robust care plans. Care plans provide staff with a clear guide of how to meet the particular needs of each young person. Care plans are completed in line with the overall looked after children placement plan with young people being encouraged to participate in the process.

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Helping children make a positive contribution

Where appropriate parents and carers are encouraged to contribute to care and review planning.

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Helping children make a positive contribution

Regular reviews ensure care plans match the current needs of each young person in an individualised fashion. The whole staff team contribute to routine child focus meetings where any change to each young person's circumstance, behaviour or emotional well being are considered fully. Reviews of care focus on the progress of the respective young person against their care plan. Similar reports are provided for statutory looked after children reviews with young people being supported to attend and participate.

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Helping children make a positive contribution

The particulars of any agreed contact arrangements are recorded in detail and are clearly known by staff and the young person concerned. Where relevant staff facilitate contact arrangements. Risk assessments are completed for such visits and updated when and if necessary. Excellent records are kept of every contact which provides a clear picture of the circumstance of visits and their outcome. 7 of 9 Inspection Report: SC067753 The atmosphere within the setting is open with young people clearly feeling comfortable in their surroundings and the staff who care for them. The complex needs of young people often include difficulties in their comprehension and ability to express how they feel. Staff have a sound understanding of the manner in which young people communicate distress, frustration and happiness and were seen to respond accordingly. It is clear young people are listened to, for instance when requests have been made for new computer games. Although a more

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Helping children make a positive contribution

formalised process for gaining and recording the views and opinions of young people is yet to be implemented a review is currently underway to establish the most tangible way to do so.

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Achieving economic wellbeing

The provision is good. No young people currently accessing services at the setting are engaged in moving on programmes as a result of them nearing adulthood. The setting have protocols in place to assist young people to learn more about independent living such as cooking and self care skills. Care plans clearly detail the needs of young people as they progress toward becoming adults in their own right.

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Achieving economic wellbeing

Young people benefit from living in a safe and comfortable environment. All areas of the home are nicely decorated with some artwork created by young people and staff being displayed around the building. Communal parts of the setting offer young people suitable space and facilities with all modern entertainment items such as TV, DVD and a computer being available. Those young people who stay long term can personalise their own rooms should they wish. A majority of the bedrooms are neutral in colour and layout so as to accommodate young people who use the service for respite care. Both the inside and outside of the home are maintained in a sound structural condition.

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Organisation

The organisation is good. Comprehensive information is provided for young people and others which details the home and the services it offers. Information is provided in a number of formats to allow young people every opportunity to understand what the home offers them during their stay.

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Organisation

The promotion of equality and diversity is good. Young people have their likes and dislikes considered when meals are planned, while their communication needs are seen as paramount in all aspects of care provision. Staff clearly understand the particular, and often complex needs, of young people in their care and respond to them accordingly. Young people have their individual needs met in an excellent fashion with support and guidance provided to match their wishes and abilities. A good staff gender balance ensures young people are looked after by both male and female carers. Wherever possible the home involve parents and carers in care programmes, clearly promoting contact and encouraging a working together ethos with placing authorities and all other care professionals.

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Organisation

Staff receive considerable support and guidance, while being empowered and encouraged to take on delegated tasks and responsibilities. Adequate numbers of staff are deployed to care for the young people during the day and night. Young people are cared for by a staff team who are committed and suitably experienced. Staff receive regular supervision and are very well guided in carrying out their tasks. The central record of supervision meetings was found to lack a number of staff signatures and was not as up to date as the level of actual supervisions 8 of 9 Inspection Report: SC067753 being completed. Staff spoken with commented positively on the manner that they are supported and guided by the registered manager and the organisation in general. Staff morale appears to be good with staff exhibiting energy and enthusiasm to carry out their tasks and develop their practice. Staff clearly understand the needs of each young person and receive very good

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Organisation

induction and training. Continued professional development opportunities are made available with the registered manager clearly keen to support and encourage staff to develop their learning and practice.

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Organisation

The registered manager and her deputies complete the routine monitoring of care provision within the setting, while the organisation complete monthly inspection visits to the home which are detailed and accurate. The subsequent reports provide an objective yet supportive review of care provision and where necessary highlight areas in need of improvement.

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Organisation

The registered manager is vastly experienced and skilled providing consistent leadership and guidance to the whole staff team. The service continues to be managed in an excellent fashion with no signs of a deterioration in standards, care provision or monitoring processes. The management approach continues to create an atmosphere which is open, inclusive and caring.

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Organisation

Young people have their progress and development acknowledged well through comprehensive and accurate records.

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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): • ensure all medicines stored at the setting are recorded as and when they are brought in and subsequently totals reduced from stock records when they are dispensed (NMS 13.10) • implement a format for gaining the views, wishes and opinions of young people who are able to contribute to decisions made about the setting and the services it offers them (NMS 8.8) • ensure the central record of staff supervision is kept up to date including staff signing to confirm their attendance (NMS 28.3) 9 of 9 Inspection Report: SC067753

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