Children's Home run by St Helens Metropolitan Borough Council in St Helens

SC035971 Unique reference number 16 June 2010 Inspection date Sonya Robinson Inspector Key Type of Inspection

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2 December 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: SC035971

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Brief description of the service

The home provides short term breaks for children and young people from the ages of seven years to 17 years, with physical, learning and sensory disabilities.

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Brief description of the service

Accommodation is provided over two floors. The ground floor includes a kitchen, two lounges, a light and sensory room, games room and dining room. Young people have their own rooms, which are located on the upper floor. The upper level of the home is accessible via a lift for those young people who use wheel chairs.

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Brief description of the service

The home is situated near a town and is close to local leisure facilities, local amenities and transport links.

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Brief description of the service

On the day of this visit, several young people were present and contributed to the inspection process.

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Summary

This visit is an unannounced full inspection including all of the Every Child Matters outcome areas, plus an additional area of organisation. The service has many strengths and works hard to maintain close supportive relationships with the young people using the service and their families.

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Summary

The home itself is now 'worn' in parts and some detail is required within the home's documentation, to enhance the positive outcomes for young people that are already provided.

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Summary

The home works very well with other professionals to ensure that young people are provided with continuity of care during stays and that their needs are regularly assessed, monitored and met.

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Summary

This is a satisfactory service overall, with some good outcome areas being indentified within this inspection. 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

At the last inspection the Registered Manager was asked to ensure that particular parts of the home received some attention, that is, a specific bedroom and the first floor landing area. Additionally, they were asked to ensure that there is an up-to-date medication policy with written guidance, which is implemented, for administering all medication, including for example, when medication is administered into food or drinks.

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Improvements since the last inspection

Also, the Registered Manager was asked to maintain adequate precautions to protect young people, staff and visitors against the risk of fire, such as reviewing the fire risk assessment on a regular basis.

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Improvements since the last inspection

All of the above have been actioned and maintained. 4 of 9 Inspection Report: SC035971

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Helping children to be healthy

The provision is good. The young people enjoy a well balanced and varied menu during their stays in the home. Individual food preferences and specific diets are well recorded and closely followed by the staff. This means that tasty food is suitably prepared and well presented, in line with any dietary needs of the young people. The use of appropriate symbols and pictures enables young people to access drinks and snacks according to their wishes. Young people with support needs at meal times, receive sensitive and discreet help at appropriate levels.

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Helping children to be healthy

Young people's current health care needs and a brief medical history, along with strategies to address the same, are outlined in clear health care plans for young people using the service. This means that young people with presenting needs receive the appropriate level of care. There is positive evidence of health care programmes, where staff closely follow suitable guidance from young people's own clinicians to address issues, such as continence or moving and handling. This means that young people with a variety of presenting health care needs, are cared for by staff with a high regard.

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Helping children to be healthy

Medication storage and administration within the home meets the standards. The service provides a secure cabinet for drugs, provided within prescribed containers by the young people's families. Medication administration records are very clearly maintained and include stock checks on medication. The individual with parental responsibility has provided signed consent for staff to administer first aid treatment and prescribed medication. This means that young people are offered medication in line with their medical prescription, and staff on subsequent shifts know when medication has been offered and administered.

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Helping children to be healthy

There are first aid trained staff on duty within each shift. This means that staff are equipped to deal with medical or accidental emergencies, such as emergency epilepsy treatment, during a young person's stay.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. The home's procedures promote the privacy and safety of young people. Staff are careful to respect young people's privacy when supporting individuals to complete continence programmes, which are discreetly completed. Young people's information is stored securely in line with internal policy and the standards. This means that young people's privacy is respected and information about them is confidentially handled.

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Protecting children from harm or neglect and helping them stay safe

The home maintains a good procedure for the collection of compliments and complaints from service users, their families and other stakeholders. The active dialogue between staff and parents, evidenced by the home's records, means that any concerns are openly discussed and followed up by staff appropriately. However, the complaints procedure no longer includes the name, address and telephone number of Ofsted. This would provide those who access the policy the choice as to whether to contact the regulator for this service.

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Protecting children from harm or neglect and helping them stay safe

Children’s safeguarding procedures are in place, with young people’s welfare a priority. Staff confirmed that they are aware of their responsibilities within the home’s child protection procedures and have received safeguarding training. 5 of 9 Inspection Report: SC035971 There is an anti-bullying policy maintained within the service, where the stated aim is to protect young people from any bullying. There is also pictorial information for young people, with regard to the zero tolerance of bullying; their slogan is 'be happy and help your friends to be happy'. These policies are reflected within the respectful relationships that young people enjoy with their peers, and of those between staff and young people. Staff work with each other and external parties in a courteous and professional manner, promoting positive role models to young people.

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Protecting children from harm or neglect and helping them stay safe

The home's protocol regarding young people going missing from care reflects the dependency levels of the service users. The home's policy is clear, meets the standards and staff are familiar with the content. This means that any episodes of missing young people would be followed up with suitable responses, reflective of the gravity of the situation.

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Protecting children from harm or neglect and helping them stay safe

Staff and young people using the service share a consistent understanding of the standard of behaviour expected from the group. This means that young people receive consistency through different care shifts when their behaviour does not meet the expected standard; typically this may involve a brief loss of an activity. The staff group maintains a log of applied sanctions, which are clear.

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Protecting children from harm or neglect and helping them stay safe

The home's policy regarding physical intervention meets the standards, and staff have received instruction in the safe control of challenging behaviours. The preferred model of physical intervention includes de-escalation and only uses restraint as a last resort, which helps to keep young people safe. The written accounts help senior staff to monitor the use of physical intervention within the home. However, not all staff are consistent in their approach when filling in the necessary documentation with regards to behaviour management.

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Protecting children from harm or neglect and helping them stay safe

The staff group are suitably trained in moving and handling techniques, which means young people can transfer between mobility aids safely. Copies of detailed assessments and risk management statements are mostly in place to provide safe moving procedures for relevant individuals. However, risk assessments do not fully detail the use of a hoist in specific parts of the home which may be in a more confined space.

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Protecting children from harm or neglect and helping them stay safe

Staff carry out regular health and safety checks of the premises, including fire safety checks. The vetting of staff and visitors is also thorough to make sure young people are protected. The home carries out robust recruitment checks before staff start work at the home; this helps to safeguard young people.

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive care and support which is suitable to their needs and promotes their abilities. Staff address the care objectives outlined within the placement plan, by maintaining a continuity of care and consistent relationships with the young people and their family members. This means that all changes in presented needs are consistently passed on to the home's staff from families, to enable good quality care to be provided to individuals. The level of both verbal and written communication between staff in the home is good, and means that staff are consistent in their approach towards individual young people. Therefore young people enjoy consistency, that optimises their abilities and helps to further develop their social and personal skills. 6 of 9 Inspection Report: SC035971 Staff within the home work together with professionals from the young people's school, to help young people and their families to access education and therapy suitable to their needs.

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Helping children achieve well and enjoy what they do

Staff have a high regard for education and ensure that during stays young people attend school daily; they also make sure that young people have appropriate equipment and that they are fully prepared for the school day.

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Helping children achieve well and enjoy what they do

Staff support and actively encourage young people to take part in leisure activities. Young people can pursue particular interests if they wish, such as local youth schemes. Young people have opportunities to develop confidence in their skills, enjoy their leisure time and try new things. The home has access to an appropriately adapted vehicle within the holidays to enable young people's interests further into the local community.

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Helping children make a positive contribution

The provision is good. The strengths and needs of all the young people using the short stay service are well assessed and their medium and short term care objectives are included within detailed placement plans. Copies of the placing social worker's paperwork with regards to the care needed, is maintained on young people's files. The home's placement plans are comprehensive and consistent with the contents of the local authority's documentation. Young people also have regular reviews which look at the quality of the service. Feedback from young people and their families is obtained prior to each review in order that their 'voice' is heard. This means that young people have their needs outlined in a plan, which is reviewed and updated as to how these needs will be implemented and met in a consistent and continual way.

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Helping children make a positive contribution

Young people spend short periods within the service, maintaining close contact with their families throughout. This promotes a partnership culture of care provided by families and the service, where young people enjoy a consistent approach by all carers.

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Helping children make a positive contribution

The service has set up a young person's consultation group to ascertain their opinions and feelings. However, the opinions and views of all children who use the service, on matters affecting them, including day to day matters are not ascertained on a regular and frequent basis, for example, through individual key worker sessions and a wider representation of the service user group, although there has been a very positive start in this area. As part of this inspection, information was sent out to young people and their families to obtain their views and thoughts about this service. In the main, the feedback was that young people really enjoy using the service and that there is a warm and caring atmosphere between the young people and staff within the home.

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Achieving economic wellbeing

The provision is satisfactory. Young people who stay at the home have a wide range of physical, emotional and learning needs and some also require specific medical and mobility support. The home supports families and young people, and assistance is given, to make the transition into adulthood, and into adult services, in many cases, a smoother process for all concerned. This can involve accompanying the young person and their family to visit various settings and staying for tea if appropriate. This means that young people receive care which helps to prepare them for, and supports them into, adulthood. 7 of 9 Inspection Report: SC035971 The service provided is warm and welcoming. Young people benefit from an environment that includes two lounges, a play room, light and sensory room and dining room. However, the home's décor and parts of the home are now looking worn in parts, despite a maintenance programme being in place.

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Achieving economic wellbeing

The outdoor area also provides young people with space to relax and play. Overall, while the standards of the accommodation and garden are satisfactory, some action is required in addition to the normal 'wear and tear' to enable the children to live as safely and as normal a life as possible during their stay at the home.

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Organisation

The organisation is satisfactory. The promotion of equality and diversity is satisfactory. Young people's rights are respected and promoted. The service demonstrates that the individual care needs of young people are identified and that direct work with young people is undertaken. Their care needs are routinely monitored through systems in place. This ensures that the individual care needs of young people are met.

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Organisation

The home provides a written Statement of Purpose which describes the service to the reader. The young people's guide is well presented within a pictorial format and is a child-friendly document, so that young people can also access the information. This means that clear information relating to the service is available for stakeholders and interested parties. However, on their last review of these documents, Ofsted's name, address and contact number have been omitted. It is a legal requirement to include details of the regulatory body, so that parents and stakeholders can access the regulator directly if they wish to do so.

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Organisation

Staff employed at the home are provided with support and supervision to maintain professional practice and review their performance. Staff are motivated and have access to a wide range of training courses which demonstrates a commitment to meeting the diverse needs of young people. However, specific training needs around aspects of disability have been identified and the service is looking into this.

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Organisation

Monthly monitoring visits are undertaken and reports contribute to the manager's evaluation of the service. Satisfactory systems are in place to measure the home's performance and monitor its progress in delivering the service.

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Organisation

Young people have accessible care records that are clear and reflect the standard of care and support delivered to each young person. Systems within the home ensure that records are well maintained and are monitored and reviewed.

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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

8 of 9 Inspection Report: SC035971 31 July 2010 ensure that the complaints procedure includes the name, address and telephone number of Ofsted (Reg 24, (4,a)) 31 July 2010 ensure that all parts of the home internally and externally are of sound construction to enable the children to live as normal a life as possible (Regulation 31 (2)) 31 July 2010 ensure that the Statement of Purpose and children's guide include the name, address and telephone number of Ofsted. (Regulation 4)

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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 that there is a clear written policy, procedures and guidance for staff with regards to behaviour management which staff are aware of (NMS 22.2, 22.3) • ensure all unnecessary risks to the health or safety of children are identified and where possible eliminated, for example, documenting when the use of a hoist is required, the possible risk involved, and what action the home plans to take to eliminate this (NMS 26.2) • ensure that the opinions of all children on matters affecting them, including the day to day matters, are ascertained on a regular and frequent basis, for example through key worker sessions and young people's meetings (NMS 8.4) • ensure that the home is decorated and furnished to a standard which creates a pleasant domestic environment appropriate to the needs of the children accommodated (NMS 24.2)

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Recommendations

• ensure that all staff receive appropriate training in order to perform their work. (NMS 31.4) 9 of 9 Inspection Report: SC035971

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