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

SC399222 Unique reference number 13 January 2010 Inspection date Kevin Whatley Inspector Key Type of Inspection

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11 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: SC399222

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Brief description of the service

The service aims to provide intensive programmes of care and support to up to three young people aged between eight and 11 on admission. Young people admitted to the setting will have a learning disability or complex needs such as autism. The nature of the service means that a majority of placements will be medium term in duration ranging from approximately 12 months to two years. Education forms a strong part of any placement with the home being purpose built with teaching facilities on site; tuition is provided via an outreach programme as part of an agreement with a local specialised school.

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Summary

This was the first inspection the service has received since it was registered. The key inspection was announced and took place on a weekday. One action and 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, in particular the specific emotional needs are considered in detail and implemented as part of a holistic care approach. Robust procedures and policies are in place to protect young people from the risks of harm with staff receiving good training in safeguarding matters. The individual needs of young people are met extremely well 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

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Summary

and at regular intervals thereafter. Young people benefit from living in a well maintained and comfortable home. The setting is managed well with committed and caring staff providing care and support in a manner which meets the individual needs of young people. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

This is the first inspection since the service was registered and therefore no previous actions or recommendations would have been made.

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Helping children to be healthy

The provision is good. Young people benefit from receiving meal provision which takes into account their choices and any special dietary needs. Staff are mindful of how each young person manages meal times bearing in mind their learning difficulties. Young people are offered a varied and healthy diet with a dedicated cook having just been appointment. Young people are given opportunities to try new foods if it is felt that the particular young person can accomplish this and if their parents or guardians agree. Mealtimes are carefully planned events with the needs of each young person being considered fully to ensure they are able to consume their meals in a manner they can manage.

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Helping children to be healthy

The health care needs of the young people are met very well. Health care plans highlight the specific physical, medical and emotional needs of young people and how these should be met by staff. Close liaison occurs with health professionals to ensure a joined up approach in meeting individual needs with specialist input sought and provided when necessary. Being a specialist 4 of 9 Inspection Report: SC399222 service the setting can readily utilise expert resources including an occupational therapist. The complex health needs of young people are recorded in detail in their health care plans, which are regularly reviewed. All young people have written consent from their parent or guardian with regards to the administration of medication and giving of first aid.

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Helping children to be healthy

The home has a good system for ensuring the storage and administration of medication is addressed safely. Medication is only given by staff who are trained to do so, while a number of senior staff are trained in dealing with emergency care such as seizures.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. 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

The learning difficulties of the young people means that they may not have the ability to understand the concept of what constitutes a complaint. Nevertheless details of how young people can complain are provided in various formats such as pictorial guides. Parents, carers and placing authorities are given information as to how to raise concerns or complaints. Contact can also be made with independent advocacy services on behalf of young people should this be deemed appropriate. A majority of young people accessing the service will have their parents as their main advocate. Staff clearly know the young people in their care and understand how they would express happiness, frustration or concern. Staff receive training in complaints and whistle blowing as part of their induction process. No complaints have been received by Ofsted since the service opened.

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Protecting children from harm or neglect and helping them stay safe

Young people are kept as safe as possible from the risk of harm. All members of staff receive child protection training and refresher courses routinely. Additionally they have access to local safeguarding procedures and the organisation's child protection policy. Staff 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.

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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. Close supervision and support of the young people ensures that the opportunity for incidents of this nature to take place is extremely rare. Similarly the risk of young people running away from the home is very limited. 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

Young people have their challenging and risky behaviours responded to in an individual, well planned and sensitive manner. 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. All staff are trained in the use of physical intervention with clear records being kept and 5 of 9 Inspection Report: SC399222 monitored of incidents as and when they occur. The level of restraints being used at the setting is currently low.

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Protecting children from harm or neglect and helping them stay safe

The whole staff team work extremely hard to provide focused responses to particularly challenging and complex behaviours, notably through the first few months of operating. Such an approach has led to the reduction in inappropriate behaviours and improvements in daily routines. The commitment shown by staff to provide consistent and professional care under extremely difficult and challenging behaviours is excellent. Regular reviews take place involving expert child care consultants to ensure any behaviour management plans are carefully considered and monitored.

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Protecting children from harm or neglect and helping them stay safe

Given the comprehension issues many young people will have the implementation of sanctions are seldom used. Clear procedures are in place should the use of sanctions be seen as necessary and worthwhile.

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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 engage in. Individual risk assessments are completed on young people with regards to their behaviour and potential vulnerability, such as going missing, travelling in cars, swimming, bathing, eating or cooking and playing. Such assessments provide staff with an obvious guide as to the most appropriate way to address difficult or problematic situations with the young person in question.

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Protecting children from harm or neglect and helping them stay safe

Regular checks of the premises and safety equipment are carried out to ensure all those who live and work at the setting are kept safe. These include fire fighting apparatus, portable electrical equipment and gas appliances. The testing of fire alarms is carried out weekly, while a majority of staff received fire safety training prior to the home opening. However there has yet to be a fire drill/evacuation with no evidence or records of the emergency lighting system being tested or the induction of new staff in fire safety.

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Protecting children from harm or neglect and helping them stay safe

The recruitment of staff is subject to vigorous procedures including Criminal Records Bureau checks and references being confirmed prior to staff beginning their employment.

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive care, support and guidance which matches their individual needs. Their assessed needs are well documented with care plans being developed in line with these. There is recognition that each young person has differing capacities, desires and needs with all staff working as a team to provide a holistic and joined up care approach. Being a specialised service most of the young people being placed in the home may stay for approximately 12 to 18 months. The intensive programmes make close and beneficial relationships with staff possible and is a cornerstone of any provision. Key working practices ensure named staff play a fundamental role in overseeing each placement and the provision of focused and intensive programmes of care. The small size of the setting coupled with the focused care and educational programmes ensures that staff gain a comprehensive understanding of the individual needs of each young

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Helping children achieve well and enjoy what they do

The functioning and purpose of the service places education as a key aspect of each young persons placement at the setting. Young people attend schooling which is facilitated within the home; this being provided by a local specialist school as part of their outreach programme. 6 of 9 Inspection Report: SC399222 As this is on the same site as the home it gives ample opportunity for teaching and care staff to work closely together. Plans for learning are shared across the staff team thus providing a consistent approach to the work undertaken with young people. Progress made in education is carefully monitored and all reviews are attended by the staff of the home. Education programmes are developed with the specific needs and abilities of young people as the guiding principle.

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Helping children achieve well and enjoy what they do

A good range of activities are available to the young people. The activities are planned to make the most of individual interests and abilities. There are sufficient staff to ensure both individual and group activities are enjoyed. Young people are supported to attend activities within the community such as swimming, but also have access to facilities in the organisations other service across the road.

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Helping children make a positive contribution

The provision is good. Young people are not admitted to the service without first having a full assessment of their needs completed. As a specialised service the needs of young people have to match the aims and objectives of the setting. As a result it is unlikely that unplanned or emergency placements would be considered.

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Helping children make a positive contribution

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 the manner they communicate, their abilities and other complex care 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. Each review of care focuses on the progress of the respective young person against their care plan. Detailed reports are provided for statutory reviews when necessary with good evidence of the setting working in partnership with placing authorities and parents.

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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. Given the service is focused on providing a specific and time limited amount of intensive care the need to maintain contact with parents and carers is essential and will most likely form part of the overall care plan. It is felt that a majority of young people using the service will have very regular contact with their parents and family.

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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 particular ways of communicating and these are recognised by the staff working with them. As noted earlier, few of the young people are able to verbalise their thoughts and feelings and so rely on augmented communication methods. Staff are aware of how young people communicate although at this current time a tangible process for evidencing how they are involved in decision making about the setting is limited.

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Achieving economic wellbeing

The provision is good. 7 of 9 Inspection Report: SC399222 The age range in which the service offers care and intervention means that the need to provide or engage young people in pathway planning will not be necessary. However individual targets can be set to assist young people to engage in life skills work which may assist them in the future.

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Achieving economic wellbeing

The home is purpose built and provides good quality accommodation. The home is domestic in style and provides attractive and comfortable accommodation. All young people have their own rooms and can personalise it with their belongings. There is a good range of communal areas including a large lounge and outdoor courtyard. The setting was found to be clean and hygienic with staff working extremely hard to maintain a healthy and safely maintained environment.

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Organisation

The organisation is satisfactory. 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

The promotion of equality and diversity is good. 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 have to be carefully catered for, notably how they communicate their needs and feelings. Diversity and difference is seen as an opportunity to learn from each other and to be enjoyed and celebrated. The manner in which staff have met the individual needs of young people alongside their particularly challenging behaviours is excellent.

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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. A thorough induction programme ensures new members of staff are prepared for working in the home. The committed staff team has enough experience, qualifications and skills to offer good levels of support to the young people.

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Organisation

The registered manager is also the registered manager of a larger, though less intensive, service for young people with learning disabilities operated by the same organisation which is situated across the road from this setting. The registered manager has a wealth of experience and is clearly able to manage both services simultaneously. An experienced deputy manager is in place to ensure a consistent managerial response should the registered manager not be available. Close working between the registered manager and their deputy ensures all aspects of the service are monitored regularly. The setting is managed very well with clear and obvious leadership ensuring staff are supported and guided to provide focused and intensive care programmes.

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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 8 of 9 Inspection Report: SC399222 indicate which areas of the home need improvement. The manager and their deputy 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 a good standard.

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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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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

18 February 2010 ensure fire drills/evacuations are carried out and recorded as required and in accordance with Regulation 32. (1) (e) (NMS 26.8)

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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 records of restraints describe the exact circumstance of events and their outcomes (NMS 22.9) • ensure any person/s completing Regulation 33 inspections sign particular restraint records to evidence they have reviewed them (NMS 22.11) • ensure that when new staff have received fire safety induction that this is recorded in the appropriate log. (NMS 26.1) 9 of 9 Inspection Report: SC399222

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