Children's Home run by The Together Trust in Stockport

SC025745 Unique reference number 4 August 2010 Inspection date Monica Hargreaves Inspector Key Type of Inspection

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20 October 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: SC025745

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Brief description of the service

This children's home is owned and managed by a charitable organisation and provides a short breaks service for up to five young people of either sex. Young people are aged from five to 17 years and have autistic spectrum disorders and/or challenging behaviour.

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Brief description of the service

The house is close to a small shopping centre and there are a range of local amenities within a short distance. There are five bedrooms, a lounge, sensory room and computer room. There are sufficient bathroom and toilet facilities for all the young people who use the service. The house has been adapted to provide a safe environment for the young people who stay there. It has a large enclosed garden with suitable toys and equipment.

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Brief description of the service

The home currently provides a service to 34 young people at different times. There were five young people present at different times during this inspection.

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Summary

At this unannounced full inspection, the key standards in all outcome areas were assessed. The recommendation made at the last inspection was also considered.

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Summary

The home provides a good standard of care and has many areas of strength. Young people's health needs are met very well and they are given an excellent level of individual support. Safeguarding has a high priority in the service and there are highly effective systems in place to ensure that young people are looked after safely. Communication with families is excellent. Their views are regularly sought and acted on. Parents speak highly of the service and feel confident that young people are safe and well cared for. Complaints are well managed and bullying is not an issue in the home.

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Summary

Staff have a very positive view of the young people they look after and are skilled at communicating with them. They are keen to help young people to enjoy their stay and they make sure that young people are able to take part in a range of activities.

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Summary

The organisation ensures that staff are trained to understand the needs of the young people they care for and staff feel that they are well supported in their work.

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Summary

Shortfalls identified during this visit relate to staff qualifications and some areas of recording as well as to some areas of refurbishment in the home. 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

One recommendation about staff qualifications was made at the last inspection. Staff continue to receive support and time to complete the National Vocational Qualification at level 3 in Caring for Children and Young People but the target remains unmet. The recommendation is therefore carried forward.

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Helping children to be healthy

The provision is outstanding. 4 of 9 Inspection Report: SC025745 Young people receive excellent support from staff with regard to their health and emotional well-being when they stay in the home, although parents retain the responsibility for the overall health care needs of their children.

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Helping children to be healthy

Initial assessments are thorough and health care plans that are drawn from those assessments are detailed. Plans address the physical, psychological and emotional well-being of young people as well as any specific needs that arise from their culture or religion. Information about young people is routinely monitored to ensure that it is kept up to date and accurately reflects their ongoing and changing needs. Care staff are trained to understand the complex needs of the young people in their care and they work closely with parents and health professionals outside the home. This promotes consistency in the care of young people.

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Helping children to be healthy

Young people are encouraged to eat a balanced and healthy diet when they stay in the home to promote their good health. Staff are skilled at communicating with young people who do not use language, which enables them to help young people to make choices about their meals. Menus take into account young people's preferences and specific requirements and are also planned to enable young people to experience foods from other cultures. Due to their specific needs, some young people have diets that are self-limiting. Staff work hard to encourage young people to try different foods to broaden their experiences. However, they also recognise that as young people have limited stays in the home, it is not always possible for them to have a significant impact on some young people's eating patterns. In these circumstances, they work closely with families and health professionals to ensure that young people are appropriately

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Helping children to be healthy

All young people are actively encouraged to take part in chosen activities which they enjoy and which help to keep them active. For example, young people go swimming, play football, go for walks and enjoy using the play equipment in the garden.

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Helping children to be healthy

There are robust procedures for the safe storage, handling and recording of medicines. These protect young people and promote their well-being. Staff are all trained in the safe delivery of medication and they have a very clear understanding of the different medicines young people take. Medications and records are regularly monitored by senior staff in the home. Staff are initially trained in first aid procedures and this training is kept up to date. This ensures that they know how to care for young people and keep them safe in an emergency.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. Young people are safely cared for because staff are well trained and show a clear understanding of the caring task. Staff respect the privacy of young people and carry out personal care tasks in a way that promotes their personal dignity, achieving a balance between safety and the promotion of personal space. There are clear boundaries which promote safe working practice.

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Protecting children from harm or neglect and helping them stay safe

The arrangements for complaints and child protection are safely managed. Complaints are responded to promptly and investigated thoroughly, so that young people and their parents can see that their concerns are taken seriously. Staff have an excellent understanding of how individual young people make their views and dissatisfactions known and advocate well for them. Training in safeguarding is undertaken by staff during their induction to the home and is regularly renewed, so that the knowledge of staff is kept up to date. Staff have a very good understanding of the home's policy and procedure and of their individual responsibility to 5 of 9 Inspection Report: SC025745 recognise and report any concerns. There is evidence that safeguarding issues are responded to promptly to protect young people.

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Protecting children from harm or neglect and helping them stay safe

Bullying is not an issue in the home but staff remain vigilant to the possibility that, on occasion, young people may target one another. There are sound systems in place to protect young people. For example, individual risk assessments on young people enable staff to identify concerns and to put in place appropriate strategies to manage them. Although these individual plans are clear there is no specific risk assessment of the home itself to ensure that the likelihood of bullying is fully countered. Short breaks are carefully planned so that young people who do not get on are not cared for at the same time. Staffing levels are very good, which means that young people are very well supervised. These measures protect young people.

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Protecting children from harm or neglect and helping them stay safe

The service has a protocol to manage unauthorised absences and there have been no incidents of young people going missing from the home. Because of the vulnerability of the young people, staff make sure that they know their whereabouts at all times and that they do not leave the home unsupervised.

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Protecting children from harm or neglect and helping them stay safe

Staff have a very positive view of the young people in their care. They encourage positive behaviour in the home by undertaking individual work with young people using techniques and resources that are appropriate to their individual needs and understanding. For example, they use 'social stories' with symbols and simple pictures to work through different scenarios with young people. All staff are trained to manage difficult or challenging behaviour positively. This includes training in the use of appropriate physical restraint. This is only ever used as a last resort and in clearly defined circumstances to protect young people and staff. Sanctions are not used as staff believe that these are not appropriate to the needs and understanding of the young people who use the service. There is clear evidence that staff are successful in the way that they work with young people. There have been two incidents in the past 12 months

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Protecting children from harm or neglect and helping them stay safe

which have resulted in physical intervention and this was at the lowest level needed to protect the young person. Young people behave well and are able to be kept safe and to enjoy their stay in the home.

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Protecting children from harm or neglect and helping them stay safe

Health and safety matters are managed very well. All equipment and gas and electrical installations are regularly checked. There are a range of risk assessments for potential hazards in the environment and activities which are regularly reviewed and kept up to date. All staff undertake fire awareness training and young people take part in regular fire drills so that they learn how to evacuate the building safely in an emergency.

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Protecting children from harm or neglect and helping them stay safe

Robust recruitment and vetting practices ensure that staff and visitors to the home are thoroughly checked. This protects young people from individuals who may pose a risk to them.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people receive an excellent level of individual support which ensures that their specific and diverse needs are met when they use the service. Detailed person-centred plans promote consistency in the team. Staffing levels are set according to the individual needs of young people, which means that they are supported by identified members of staff throughout their stay. There is an established key working system, with a named individual who takes responsibility for making sure that plans are implemented, although all staff take equal responsibility for caring for young people at different times. 6 of 9 Inspection Report: SC025745 Young people's education needs are supported very well by staff during their stay in the home, although parents are responsible for the overall education needs of their children. Staff work closely with parents and schools to actively promote the value of education. Key workers visit

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Helping children achieve well and enjoy what they do

schools to ensure that the service and school offer a consistent approach. Detailed records are maintained in respect of young people's achievements in school and staff attend education reviews. The service provides good educational facilities and play equipment to enhance young people's general learning, such as a computer, books, games and arts and crafts materials. There is a well-equipped sensory room that young people enjoy using and swings, trampolines and bicycles in the garden.

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Helping children make a positive contribution

The provision is outstanding. Young people's needs are clearly set out in detailed person-centred care plans, that are developed with the involvement of parents. These are supplemented by a range of individual risk assessments and where appropriate, behaviour support plans. This means that there are clear strategies in place to enable all staff to provide consistent care to young people. The care of young people is regularly monitored in the home and reviewed through formal systems, so that plans are kept up to date and relevant to the ongoing needs of the young people. Parents value the detailed quarterly reports about their child's progress that the home sends them. Parents make positive comments about the regular contact that staff have with them. These systems keep parents well informed and give them confidence in the way their children are looked after.

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Helping children make a positive contribution

The promotion of family contact is not generally an issue for the young people who use this service, as they live with their families. However, where there is a need to facilitate family contact staff provide practical and emotional support to make sure that this happens. Young people have access to a telephone that they can use to contact their families when they stay in the service, if they are able and if they wish to do so.

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Helping children make a positive contribution

Admissions and discharges from the service are managed very well to lessen anxiety and support young people and their families at a time of transition. Young people are introduced to the home in a gradual and planned way at a pace that meets their needs. Staff work closely with families and local authorities throughout a young person's placement, to help them move on from the service in as planned a way as possible.

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Helping children make a positive contribution

Consultation with young people, parents and social workers is highly effective and a real strength of the service. Staff develop a very good understanding of the young people in their care and they are skilled in using a variety of ways of communicating with those young people who do not use speech. This means that they are able to help young people make their views known. Staff also communicate very well with parents. They make regular contact by telephone and send out questionnaires asking for parents views on the service. Parents make many positive comments about the care given to young people in the home. For example, 'this is a fantastic service', 'staff look after young people very well and they are loyal and caring people', 'I couldn't be more satisfied with the quality of the care provided'.

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Achieving economic wellbeing

The provision is good. 7 of 9 Inspection Report: SC025745 Staff promote independence. They help young people to gain life skills when they stay in the home at a pace and level that is appropriate to their individual needs and abilities. All of the young people who use this service will require ongoing support as adults. Local authorities consult with families and staff in the service about plans for young people when they become adults. However, there are often delays in the development of local authority transition plans and the lack of formal plans for young people who are approaching 18 years of age, means that they are less able to make a smooth transition into adult service provision. The home has implemented its own system of transition planning to begin to address this shortfall.

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Achieving economic wellbeing

The service provides young people with an environment that is safe, homely and comfortably furnished. There is sufficient communal and private space for the needs of the young people who are accommodated in the home at various times. The home is clean and tidy and generally maintained to a good standard. However, there are some areas that would benefit from refurbishment. Also, young people's bedrooms, although large, airy and brightly decorated, lack homely touches. Staff comment that there is a plan in place to enable all young people to put up pictures, posters and art work of their choice, that can be changed for the next young person using the room.

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Organisation

The organisation is good. Information about how the service works and how young people are looked after is given to parents, young people and social workers. The Statement of Purpose is clear and detailed, although the most recently updated document does not specify the ages of children looked after, which does not meet the standard. The young person's guide is produced in a format that is suitable to the needs of the young people who stay in the home. The service also produces a separate document for parents which gives them good information about the home. This is good practice.

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Organisation

Young people benefit from being cared for by staff who are trained and who understand how to meet their complex needs. Staff say that they are well supported in their work. The organisation is committed to ensuring that all staff gain a National Vocational Qualification at level 3, or equivalent. Staff are working to complete this, but the target of 80% of staff having achieved a qualification is not yet met. Staffing levels are good and there are sufficient staff on duty at any one time to ensure that young people are well looked after, kept safe and can participate in activities that they enjoy.

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Organisation

There are effective management systems in place in the service. The manager checks records regularly and ensures that staff are supervised and their work is monitored. Checks are also undertaken by a senior manager in the organisation. These systems of monitoring ensure that good standards of care are maintained in the home.

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Organisation

Young people's files contain detailed information that provides them and their families with a clear history of their stays in the service. Files are well maintained and kept up to date, so that staff have the information they need to care for young people appropriately during their stay.

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Organisation

The promotion of equality and diversity is outstanding. Staff are trained in these issues and there are policies to guide their practice. There is a strong approach to implementing equality and diversity in the home. Staff advocate well for young people and promote an ethos in the service that ensures that disability is not seen as a bar to inclusion. They actively challenge 8 of 9 Inspection Report: SC025745 discrimination. Young people are recognised and valued as individuals and staff demonstrate a clear commitment to providing a service to them that is flexible and tailored to meet their specific needs.

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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): • carry out a recorded assessment of the times, places and circumstances in the home in which the risk of bullying is greatest (NMS 18.5) • ensure that there is a comprehensive transition plan in place for young people who are preparing to leave the service (NMS 6.1) • ensure that all areas of the home are maintained in a good state of structural and decorative repair and that young people are able to personalise their bedrooms (NMS 24.3) • include in the Statement of Purpose the details of the age range of children and young people to be cared for (NMS 1.2) • ensure that a minimum of 80% of all care staff achieve a National Vocational Qualification at level 3 in Caring for Children and Young People or an equivalent qualification. (NMS 29.5) 9 of 9 Inspection Report: SC025745

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