Amersham Hospital Day Nursery

Amersham Hospital Day Nursery

Inspection report for early years provision

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Amersham Hospital Day Nursery

Unique Reference Number EY260961 Inspection date 15 December 2005 Inspector Jane Plested / Sonjia Nicholson

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Amersham Hospital Day Nursery

Setting Address Amersham Hospital, Whielden Street, Amersham, Buckinghamshire, HP7 0JD Telephone number 01494 734 251

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E-mail

Registered person Buckinghamshire Hospitals NHS Trust Type of inspection Integrated Type of care Full day care

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E-mail

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000

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ABOUT THIS INSPECTION

The purpose of this inspection is to assure government, parents and the public of the quality of childcare and, if applicable, of nursery education. The inspection was carried out under Part XA Children Act 1989 as introduced by the Care Standards Act 2000 and, where nursery education is provided, under Schedule 26 of the School Standards and Framework Act 1998. 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 outcomes for children set out in the Children Act 2004; the National Standards for under 8s day care and childminding; and, where nursery education is provided, the Curriculum guidance for the foundation stage. The report includes information on any complaints about the childcare provision which Ofsted has received since the last inspection or registration or 1 April 2004 whichever is the later.

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The key inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough For more information about early years inspections, please see the booklet Are you ready for your inspection? which is available from Ofsted's website: www.ofsted.gov.uk.

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THE QUALITY AND STANDARDS OF THE CARE AND NURSERY EDUCATION

On the basis of the evidence collected on this inspection:

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THE QUALITY AND STANDARDS OF THE CARE AND NURSERY EDUCATION

The quality and standards of the care are good. The registered person meets the National Standards for under 8s day care and childminding.

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THE QUALITY AND STANDARDS OF THE CARE AND NURSERY EDUCATION

The quality and standards of the nursery education are good.

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WHAT SORT OF SETTING IS IT?

Amersham Hospital Day Nursery opened over 20 years ago. It operates from purpose built premises situated within the grounds of Amersham General Hospital in Old Amersham. The nursery primarily serves children whose parents work for Buckinghamshire Hospitals NHS Trust, but a number of places are available to children living in the local area. There are a total of 6 dayrooms used to care for children, 4 sleep rooms, 2 kitchens, an office, staff room, and both staff and children's

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WHAT SORT OF SETTING IS IT?

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000 toilet facilities. There is a secure, enclosed, children's outside play area. A maximum of 80 children may attend this nursery at any one time. There are currently 84 children from 3 months to 5 years on roll. This includes 25 children who receive funding for nursery education. Children attend for a variety of sessions. The nursery has facilities to support children with special educational needs and is supporting a number with English as an additional language. The nursery is open Monday to Friday from 07.15 to 18.00 throughout the year, except for Bank Holidays and staff training days. There are 26 staff who work with the children, 23 of whom hold early years qualifications to NVQ level 2 or 3 in childcare and education. The setting receives support from the Local Authority.

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Helping children to be healthy

The provision is good. Children’s health benefits from the effective routines within the nursery and practitioners following good practice regarding hygiene. The premises are warm and well maintained and all nursery surfaces are clean and wiped regularly. Practitioners regularly wash the toys and resources that children use. Children follow good personal hygiene routines. Those that are more able know that they are washing their hands ‘to get rid of germs’. Nappy changing routines are good. Practitioners are prompt to use tissues to wipe children’s runny noses. Children’s drinking vessels have name labels. These procedures contribute to effectively reducing the risk of infection amongst the children. Children enjoy a wide range of activities that support their good physical health. Practitioners provide these within the daily routine and planned curriculum. Children have frequent access to the outdoor play area and regularly go for walks close to the

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Helping children to be healthy

nursery. As a result, they have plenty of fresh air and exercise. Children also have opportunities to develop their large muscles and co-ordination and balance, as they climb on apparatus, peddle tri-cycles and take part in music and movement activities. For example, children have fun as they jump to ‘sticky kids’ tapes and move enthusiastically to familiar songs such as ‘Heads, Shoulders, Knees and Toes’. As a result, children are developing increasing control of their bodies. Children have access to drinks throughout the day. These are available in each day room, and practitioners offer them routinely mid session to children, thus ensuring they do not get thirsty. Meals are varied, well-balanced and take account of individual and cultural needs. Children eat heartily, enjoying lunchtime dishes such as roast turkey and wholemeal toast at snack time. Those that are more able enjoy serving their own second helpings of lunch, developing a sense of independence. Children sit

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Helping children to be healthy

in small social groups with practitioners who encourage them to develop good life skills.

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Helping children to be healthy

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Children benefit from practitioners' good understanding of how to keep them safe. The dayrooms are set out to take account of their health and safety, thus reducing the likelihood of accidents. Practitioners closely supervise children as they play, move around the nursery or go on walks, during which they use appropriate safety equipment, such as reins. Practitioners provide appropriate opportunities for children to take risks under controlled circumstances. For example, as they climb on adventure play equipment; showing a good understanding of the importance of giving children freedom within safe limits. Older children are learning to cross quiet roads and know to ‘stop and look to the side’ before crossing. As a result, children learn to be safe, take responsibility and to develop independence. Children have access to and use a wide range of high quality toys and equipment, which are age and developmental-stage appropriate. The resources are made of

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Protecting children from harm or neglect and helping them stay safe

both synthetic and natural materials and there are effective systems for ensuring they remain clean and safe for children to use. Children are safe and secure, as there are suitable procedures in place to maintain children’s security, such as a locked front door. Practitioners are familiar with the child protection policy and the signs that cause concern about children’s well-being. Consequently, they have sufficient knowledge to protect the children in their care. However, the procedures they follow for monitoring children’s pre-existing injuries may result in a lack of information being available in the event of a concern.

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Helping children achieve well and enjoy what they do

The provision is good. Children build close relationships with practitioners who are skilled at settling, comforting and stimulating them. One child, who is slightly upset at being left, is comforted and quickly settled into the activity by the practitioner. Interaction with babies by staff is of high quality, as practitioners cuddle, chat to and obviously enjoy working with them. Practitioners provide a warm and secure experience for babies during milk feeds and nappy changes. They do this, for example, by talking to them and maintaining eye contact throughout these procedures. All ages of children are familiar with the well-planned daily routine and they are comfortable in the premises and move around confidently. Consequently, children are contented and secure, developing a sense of trust. Children of all ages benefit from the planning done by practitioners. They are fully involved in a varied programme of activities that support their learning and

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Helping children achieve well and enjoy what they do

development. Babies enjoy using a range of heuristic resources, as they enthusiastically bang spoons on tins. All ages of children attending the nursery enjoy familiar songs, and participate in movements. For example, ‘Toddlers’ join in with ‘If Your Happy and You Know It’ and ‘Tweenies’ enthusiastically participate in ‘The Crocodile Song’. This develops children’s vocabularies and listening skills, and provides opportunities for them to have fun. All ages of children enjoy and listen

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Helping children achieve well and enjoy what they do

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000 attentively to stories. Children in ‘Tweenies’ thoroughly enjoy an expressively read story called ‘All Change’, with which they are clearly familiar. They have fun as they predict and join in with the title line as it recurs in the story. As a result, children learn to gain pleasure from books and develop concentration skills. Nursery Education The quality of teaching and learning is good. As result, children are making very good progress in all areas of their learning. Practitioners offer an interesting and varied curriculum and help children learn through effective questioning techniques. For example, during activities they ask open questions such as ‘where do the presents go?’ providing an opportunity for a response using positional language, they go ‘under the tree’. Planning for learning in the ‘Big Room’ is systematic and covers all

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Helping children achieve well and enjoy what they do

areas of the curriculum but there are some weaknesses in plans for the ‘Middle Room’. Practitioners know individual children’s stage of development and are often aware of a child’s next stage for learning. However, they are moving children on intuitively as plans do not yet identify targets for children learning. There is no evaluation of the success of individual activities to inform future planning as a result; practitioners may miss when they are successful. Suitable assessment records are in place for documenting children’s progress. Children often learn through first hand experiences, for example, local walks enable them to look at natural world as they collect bugs and observe the effects of changing seasons. Practitioners provide children with clear explanations about how to complete tasks. For instance, one practitioner reminds a child to carry tray with both hands so the toast does not fall off.

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Helping children achieve well and enjoy what they do

Consequently, children are successful and develop high self-esteem. Practitioners ensure all children get the opportunity to participate. They involve all of the group in counting activities during the story, and monitor children’s participation in planned activities. Thus, they are effective in ensuring children’s full involvement in nursery activities. Children learn to behave well as practitioners are good role models and encourage manners and as a result, children know how they must sit at the table. Children’s communication skills are strong and they are extremely confident in their interpersonal relationships with their peers. They are able to talk about their sticking activity when asked. Children confidently ask questions of the practitioner during activities and of other adults, they meet. At circle time, one child describes his recent experience of going to the doctor and other children ask him questions about it;

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Helping children achieve well and enjoy what they do

demonstrating that the children have good language skills, confidence and learn a strong sense of self-worth. Children are aware of rules and know that they must share. One more able child says ‘we are not to take to large a second helping of lunch, so there is some left for other children’. This shows that children are developing an ability to take account of the needs of others. Children use books independently; they listen very attentively to a story called ‘The Christmas Kiss’. One more able child confidently tells the inspector the story of ‘The Three Billy Goats Gruff’ in detail, turning the pages of the book when appropriate. This demonstrates that children are developing a familiarity with books, and some children have strong vocabularies. Children can link letters to sounds and recognise their own names. However, they lack sufficient opportunities to develop mark making and writing skills. For example, they are not encouraged to practice their emergent

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Helping children achieve well and enjoy what they do

writing by naming their work. As a result, children do not have sufficient opportunities

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Helping children achieve well and enjoy what they do

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000 to develop these skills. Children benefit from the frequent opportunities to count. A more able child counts confidently to 20 independently and recognises the numerals for numbers below 12 out of context. Practitioners encourage children in the Big Room to develop calculation skills during group counting activities, such as adding the total number of boys and girls present. Children do this successfully. One younger child uses mathematical language to describe the size of a toy dog. Consequently, children are making very good progress in their mathematical development. Children have opportunities to explore a broad range of different textures for example; they have access to sand or dough with added raisins. They learn to observe weather conditions by looking out of the window daily as they complete the

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Helping children achieve well and enjoy what they do

calendar. Children are encouraged to paint freely and to use a wide range of resources in their collages. For example, children select from wool, sequins, shiny paper and glitter as they make angels. Displays of colourful drawings by children of themselves and their families show that they are able to draw creatively and with skill. They use a range of tools, such as scissors and spatulas, well. Consequently, they learn about colour, texture and develop their imaginations and manipulative skills.

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Helping children make a positive contribution

The provision is good. The setting welcomes a wide range of children and families. The nursery takes account of young children’s daily routines and of religious and cultural preferences. Practitioners are working with parents well to support individual children’s development. There are some images of differences with in the resources and children are encouraged to celebrate a range of festivals. However, practitioners miss opportunities to develop other children’s understanding of the home cultures and languages of their peers and of appropriate aspects of disability. Children behave very well and benefit from opportunities to help and take responsibility. For example, all ages help tidy away and older children complete simple tasks such as carrying the register to another day room. Practitioners provide positive role models as they speak to children respectfully. They praise them regularly and encourage good manners at the lunch table. They do this by ensuring

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Helping children make a positive contribution

children sit properly at the table for meals and encourage them to use please and thank you. Consequently, children develop self-esteem and use words like ‘thank-you’ spontaneously. Overall, the children’s spiritual, moral, social and emotional development is fostered. Strategies for working in partnership with parents and carers are good. Parents overall, have ample opportunities to access helpful written information about the nursery and they are welcome in the setting as an ‘open door policy’ is in place. There are strong links between practitioners and parents. They comment that staff are very caring and friendly. Practitioners share information on children’s progress twice-yearly during parent evenings although some newer parents are not aware of this. As a result, children’s parents feel very confident and happy about the quality of care their child’s receives.

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Helping children make a positive contribution

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000

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Organisation

The organisation is good. Leadership and management within the nursery are good as a result, it is very well organised to provide care and education for children. There are many effective policies and procedures in place. Children are grouped well so they learn at an appropriate pace and can develop relationships with peers and staff. The setting is warm and welcoming for children, with displays of work and good quality toys and furnishings for them to use. Resources are accessible for children developing a sense of independence. As a result, children feel secure and settle quickly. The quality of childcare benefits from a team with a high ratio of qualified staff who have good support systems. As a result, practitioners are confident in their work demonstrate good team spirit and are familiar with the policies and procedures. The setting meets the needs of the range of children for whom it provides.

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Organisation

All the appropriate records on children’s care, health and welfare are in place. Most follow a confidential format and are stored safely. However, entries in the record of medication are not confidential to the individuals concerned. Additionally they omit some detail for example, the name of the medication or dose they are to administer are missing. Consequently, there is a risk of error. Although the nursery discusses children’s pre-existing injuries with parents they have not thought to regularly record these and, as a result, some information about children’s welfare may be lost.

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Improvements since the last inspection

At the last inspection the nursery agreed to ensure that staff in the lower end of the setting are deployed effectively at lunchtime to ensure all children's needs continue to be met. They also agreed to obtain prior written permission from parents before administering any medication to children. Lunch and other meal times throughout the nursery are now well organised and staffed appropriately. As a result, children have a positive experience during mealtimes. Written agreements are now in place regarding the administration of medication. Therefore, parents are fully aware of and agree to this aspect of their child’s care. At the last nursery education inspection, the setting was asked to develop planning across all six areas of the curriculum. They also agreed to put in place a manageable record system to effectively assess children’s achievements and progress. Planning in the ‘Big Room’ now covers all aspects of the Foundation Stage

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Improvements since the last inspection

Curriculum. However, there are some minor weaknesses in planning for ‘Middle Room’, which has only recently catered for children in receipt of nursery education. The planning now ensures children are making good progress in their learning. The records of children’s development now clearly show their achievements and their progression in learning across the Foundation Stage Curriculum. However, these records would benefit from the use of more evaluative language, so that they

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Improvements since the last inspection

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000 demonstrate, more clearly, how well children are achieving.

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Complaints since the last inspection

There have been no complaints made to Ofsted since the last inspection. The provider is required to keep a record of complaints made by parents, which they can see on request. The complaints record may contain complaints other than those made to Ofsted.

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THE QUALITY AND STANDARDS OF THE CARE AND NURSERY EDUCATION

On the basis of the evidence collected on this inspection:

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THE QUALITY AND STANDARDS OF THE CARE AND NURSERY EDUCATION

The quality and standards of the care are good. The registered person meets the National Standards for under 8s day care and childminding.

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THE QUALITY AND STANDARDS OF THE CARE AND NURSERY EDUCATION

The quality and standards of the nursery education are good.

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The quality and standards of the care

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • provide more images of differences and take positive steps to value children's additional languages and cultures to the benefit of all children within the nursery • make sure the record of medication is maintained in a confidential format and that entries hold all the required detail and ensure that children's pre-existing injuries are recorded

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The quality and standards of the nursery education

To improve the quality and standards of nursery education further the registered person should take account of the following recommendation(s): • provide more opportunities for mark-making with in the classroom and encourage children write their name on their work • develop further the planning for 'middle room' and continue to improve recording and evaluation procedures.

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The quality and standards of the nursery education

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000 procedures set out in the leaflet Building better childcare: Compliments and concerns about inspectors' judgements which is available from Ofsted's website: www.ofsted.gov.uk

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The quality and standards of the nursery education

This inspection was carried out under the provisions of Part XA of the Children Act 1989, as inserted by the Care Standards Act 2000

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