Children's Home run by Barnardo’s in Oxfordshire

SC069128 Unique reference number 10 March 2010 Inspection date Merryl Wahogo Inspector Key Type of Inspection

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3 September 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 8 Inspection Report: SC069128

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Brief description of the service

This is a short-break service for children with severe learning difficulties and, in most cases, significant physical impairments and health needs. It is located in a residential part of the city adjoining some green space.

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Brief description of the service

It was created in February 2007 and caters for a maximum of six children at any one time, with one emergency bed, although it is rare for all six to be staying over night.

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Brief description of the service

This home provides some care in some of the families' own homes, and this aspect of the service is inspected by the Care Quality Commission.

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Summary

This was the unannounced key inspection covering all outcome areas. The home is outstanding in its efforts to maintain and promote the health of young people using the service. It is also outstanding in terms of the environment in which young people spend their time. Management and staff do everything necessary to keep young people safe. They make every effort to provide enjoyable activities for each young person during their stay. Equally, they support and encourage independence skills. The organisation is good, although there is some risk of a deterioration in staff qualifications, unless funding can be found for National Vocational Qualification courses. Staff pay excellent attention to equality and diversity issues amongst the young people, but do not yet actively promote diversity. 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

There were no areas for improvement identified at the last inspection.

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Helping children to be healthy

The provision is outstanding. The cook devises menus, in conjunction with care staff, to meet the particular dietary needs of each young person and group. This means that there is considerable variation, with some periods reflecting far more diversity than others. The cook is exceptionally good at getting to know young people's needs and habits. She strikes the right balance between giving them what they like and gradually assisting them in trying out new things.

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Helping children to be healthy

Staff pay great attention to health assessments and all aspects of medical care needed, with a significant proportion of the staff being qualified nurses. Health plans are detailed and staff are meticulous about recording every possible detail in relation to the administration of medication. There is excellent communication between parents and staff about changes in prescriptions. Equally, staff keep this home particularly clean, tidy and hygienic.

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Helping children to be healthy

Staff administer all medication in pairs so that everything is double checked before any dose of medicine is given to a young person. Records reflect this attention to detail. 4 of 8 Inspection Report: SC069128

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Personal care is needed by every young person who attends this home. Staff are clear about policies in this area, which emphasise privacy and dignity.

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Protecting children from harm or neglect and helping them stay safe

There have been no complaints since the last inspection, but several parents have sent in compliments and 'thank you' cards. For example one parent noted, '[the home] is a lovely environment, but you guys make it a really special place'. Nevertheless, parents are given all the information they may need should they want to complain.

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Protecting children from harm or neglect and helping them stay safe

Another parent says, '[the home] creates a friendly, but also safe environment'. Social workers back this up and are pleased with how well staff communicate with them on safeguarding issues. Staff, including those who are new, keep safeguarding high on their agenda and monitor closely when necessary.

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Protecting children from harm or neglect and helping them stay safe

There are clear policies and procedures in relation to bullying and absconding. These are not, however, behaviours seen in the young people attending this home.

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Protecting children from harm or neglect and helping them stay safe

It is rare that staff need to use any physical interventions to manage behaviour. Nevertheless, when they do, appropriate methods are used and are thoroughly recorded. The same is true in relation to measures of control. Staff are having discussions about whether moving a young person in their wheelchair to calm a situation, is a measure of control or a physical intervention. This indicates a lively interest and a thoughtful attitude to their work such that young people benefit from high standards.

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Protecting children from harm or neglect and helping them stay safe

The staff team are now more thorough in relation to carrying out fire checks. Currently, staff are checking all aspects at the required intervals and recording the results accurately. The acting manager ensures that risk assessments are completed and reviewed according to policies and procedures. This means that parents can feel secure that young people are being safeguarded from all potential hazards.

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Protecting children from harm or neglect and helping them stay safe

The acting manager has improved recruitment practise in two ways. In the first place, a parent participates in interview panels. Secondly, all potential recruits complete a half day shadowing a member of staff before accepting any offer of a post. This ensures that they have a clear picture of what the work involves. Young people are therefore more likely to enjoy long-term relationships with staff. Management ensure a thorough approach to every necessary aspect of recruitment checks. This means young people are looked after by staff who are most likely to keep them safe.

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Helping children achieve well and enjoy what they do

The provision is good. Management have put in place a new system of assessing in detail, expected outcomes of placements for individual young people. They are still in the process of collecting the first data for this assessment.

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Helping children achieve well and enjoy what they do

Every aspect of care is highly individualised. There is a wide range of specialist equipment to support this and many staff are highly experienced. This means that the care that any one young person receives can be vastly different from that of another, on any particular day. 5 of 8 Inspection Report: SC069128 Nevertheless, staff make great efforts to ensure that young people's visits coincide with that of others whose company they enjoy.

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Helping children achieve well and enjoy what they do

Staff glean information about educational progress from home-school books and reviews. It is hoped that the new outcome scoring system will also provide evidence in relation to education.

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Helping children achieve well and enjoy what they do

A variety of activities are available to young people. Staff encourage those who are new to the home to explore all the different possibilities.

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Helping children make a positive contribution

The provision is good. Good relationships with social workers and parents ensure that the home develops placement plans based on thorough information. Equally, staff gradually develop detailed and well written care plans. Staff always read these before the visits. This means that, despite the complexity of their care needs, young people are looked after by staff who are providing highly individualised care.

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Helping children make a positive contribution

Staff contribute to and participate in regular reviews and keep signed and dated copies. Again, parents, social workers and others all contribute to these reviews. Parents like the effort staff make to get to know them and their children. They appreciate that this means that they all have a chance to settle into using the home at the right pace. It also means staff are confident about filling the young person's needs when they attend.

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Helping children make a positive contribution

Staff enable young people to make choices in a variety of ways. For example, they might show young people food options and allow them to point to the one they want. Other times a young person might be able to lead a member of staff to the activity they are choosing.

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Achieving economic wellbeing

The provision is outstanding. Staff encourage young people to maintain or develop independence skills, such as clearing away plates. They use specialist equipment where this supports independence. For example, adapted cutlery and plates are given to young people if this means they can then feed themselves.

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Achieving economic wellbeing

This home is exceptionally attractive, with all décor being bright and in a good state of repair. The furniture is of a high quality, as well as being both functional and individualised. For example, there is one bed which is essentially made of pine, but has very high sides with large perspex panels. This allows staff to keep a particular young person safe and yet the young person can see out and be seen at all times. Staff have painted bedrooms in different colours and have named them after those colours. This means that young people can choose their bedrooms by their favourite colours.

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Achieving economic wellbeing

Young people can enjoy a variety of activity areas, including a soft playroom with a ball pool, a sensory room and a jacuzzi.

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Organisation

The organisation is good. 6 of 8 Inspection Report: SC069128 The promotion of equality and diversity is good. Staff are rigorous in ensuring that all young people attending the home are equally able to access every aspect of the service. Most of the effort in this area has gone into addressing the diversity of the youngsters in relation to impairment issues. Staff do, however, also attend to young people's religious needs. For example, they have recently recruited volunteers to say prayers at night, where parents want this. Not enough has yet been done, however, to actively promote diversity. This means that the young people may not be sufficiently comfortable with a wide range of people, foods and so on.

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Organisation

Management have ensured that parents and others can get a clear idea of the service offered, through the Statement of Purpose. This is a thorough document which is regularly updated. Staff have a good relationship with social workers. One social worker says, '[the acting manager] is very approachable and shares concerns with us. We also appreciate their willingness to help out in a crisis'.

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Organisation

The acting manager ensures that she and seniors supervise all staff regularly and appropriately. Staffing rotas are matched closely to the particular young people using the service on any one night. This includes ensuring nurses are available to those young people who have particularly complex health needs. Although there is occasionally a need to use casual or agency staff, the manager ensures that this is a consistent group of people. Indeed, some eventually become permanent staff. This means that young people meet a consistent group of staff who are familiar with them.

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Organisation

Most staff are either qualified nurses or have National Vocational Qualification (NVQ) at level 3 qualifications in care. There is, however, a recent lack of provision of NVQ training for new staff. This means there is a risk that the staff group as a whole will not be adequately trained to meet standards necessary for these young people.

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Organisation

On the whole, staffing levels are good and the organisation makes every effort to recruit where necessary. New staff go through a thorough induction programme with seniors and online. Managers then make a range of different training courses available. Staff are enthusiastic about courses such as one on autism, in which people on the autistic spectrum delivered much of the training. This means all the young people are cared for by staff who are increasingly confident in their work.

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Organisation

The organisation employs a number of different methods to monitor the quality of the service that is being delivered. This includes regular visits and reports by people external to the home as well as audits of different aspects of the home's functioning. Equally, the acting manager monitors checks and records on a regular basis.

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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 the active promotion of diversity (NMS 7) • ensure a procedure is developed whereby all new residential project workers can access NVQ at level 3 training. (NMS 29) 8 of 8 Inspection Report: SC069128

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