Children's Home run by Keys Group Progressive Care & Education Limited in Southampton

SC389174 Unique reference number 24 May 2010 Inspection date David Coulter Inspector Key Type of Inspection

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25 February 2010 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: SC389174

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Brief description of the service

This is a children’s home that offers short-term respite placements for up to eight young people who may have learning disabilities, physical disabilities, complex health needs and/or autism and associated challenging behaviours. The home, a large detached property, has been specifically converted and extended to meet the needs of the young people it accommodates and contains specialised facilities, such as a sensory room, outside play area and specially designed bathrooms. The home is situated in a residential area of a city and is accessible to a range of services and facilities including parks, health centres, schools and shops.

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Summary

The unannounced key inspection was aimed at assessing how the home was meeting the outcomes for young people as detailed in Every Child Matters and to determine compliance with minimum care standards and regulations. During the course of the inspection evidence was obtained by undertaking a full tour of the building, inspecting a range of documents and records, engaging with staff and observing a number of young people.

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Summary

The home is operating with a team of experienced and well motivated staff who provide good quality respite care to a group of young people with complex needs. Staffing levels are being maintained at an appropriate level to allow young people undertake a range of activities both in the home and in the local community. Staff spoken with during the inspection were clearly aware of their roles and responsibilities. It was also possible to observe the interaction between staff and two young people. Young people appeared to be relaxed and at ease in their surroundings and were being cared for by staff who were extremely attentive to their specific needs.

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Summary

A tour of the premises indicated that the home is structurally sound and in good decorative order. The home is purpose built and provides appropriate accommodation for young people with complex needs. Young people are provided with their own rooms that are furnished, in advance of their visits, to ensure their care needs can be effectively met. A new medication room has been created since the last inspection which provides a more secure area for both storage and dispensing.

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Summary

Evidence collected through the inspection process indicates the home is being well managed and is providing good quality respite care to a group of young people with complex needs. There are no actions or recommendations arising from the inspection. 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 requirements or recommendations made during the last inspection.

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Helping children to be healthy

The provision is good. Young people are encouraged to eat a balanced diet with appropriate quantities of fruit and vegetables. Special dietary needs, individual preferences and seasonal variations are incorporated 4 of 8 Inspection Report: SC389174 into the menu planning process. Young people can access fruit and snacks in between meals. Meals are social occasions and there is a dedicated dining area in which young people and staff can eat together. Staff are always available to assist young people who experience difficulties eating. Since the last inspection a number of improvements have been made to kitchen facilities including the introduction of a new double sink and dish washer.

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Helping children to be healthy

The health needs of young people are identified as part of the home's admissions process. As young people are normally accommodated for short periods, their health needs are met on a 'shared care' basis with their families. Staff liaise closely with parents/guardians to ensure that the health and well-being of each young person is appropriately addressed during their stays. Consents for medical interventions are obtained in advance of any admission. Staff are made aware of the particular health difficulties associated with each young person's disability and access parents and health professionals for advice. Staff also undertake specific training to address delegated health tasks.

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Helping children to be healthy

A new policy and procedure for administering medication has been introduced since the last inspection. Clearly aware of the difficulties associated with handling medication in and out of the home, the manager has created a medicines room and introduced a new dispensing system. All staff undertake medication training and have to demonstrate their competence before assuming their full responsibilities. Specific staff are identified to administer medication on each shift. Information is provided for staff on the nature of each medicine and possible side effects. Evidence indicates the new system is working effectively.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. During their stays each young person is provided with a room that is designated as their own personal space. Staff ensure that each individual is comfortable in their surroundings and personalise their rooms to meet their specific needs. Due to the nature of their disabilities, many of the young people need close supervision and require regular visual checks at night. Staff carry out such checks with minimal disruption. Personal care tasks are carried out sensitively and bathroom doors are always kept closed. Confidential information relating to each young person is kept secure in an appropriate locked facility.

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Protecting children from harm or neglect and helping them stay safe

The home operates within a risk management framework and risk assessments are extensively used to ensure the safety of both young people and staff. Risk assessments are subject to regular review and updated in response to any incidents. There are effective monitoring systems in place to ensure the health and safety of young people and staff. The home's fire alarm system is subject to weekly tests and full evacuation drills carried out at regular intervals. Access to the building is restricted and all visitors have to report to staff on admission.

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Protecting children from harm or neglect and helping them stay safe

All staff have completed safeguarding training and are aware of their personal responsibilities in regard to the reporting of child protection concerns. By the use of appropriate staffing levels, behaviour management strategies and close supervision, staff aim to protect young people both in the home and while undertaking activities in the community. Specific guidance has been produced for staff on undertaking activities outside of the home.

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Protecting children from harm or neglect and helping them stay safe

Staff use a range of communication techniques to determine the views of young people about all aspects of their placements. Consultation normally takes place informally through one-to-one discussions. Staff consult regularly with parents/guardians and report back on the progress of 5 of 8 Inspection Report: SC389174 each young person at the end of each stay. An annual questionnaire is used to gather the views of parents/guardians about all aspects of the service. If a young person, their parents/guardians or placing authority has major concerns they can access the home's complaints policy. All complaints are logged and the actions taken to resolve them noted. No complaints have been made since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Young people are encouraged to develop positive behaviour. Behaviour management plans are developed in respect of each young person and provide staff with guidance that ensures a consistent approach. Staff are fully aware that many of the young people have limited control over their behaviour and experience involuntary actions that can unintentionally impact on others. Appropriate staffing levels and close supervision minimise areas of potential difficulty. Sanctions are only applied if it is felt that the young person has insight into their behaviour. If a sanction is used, it normally consists of a short period of 'time out'. All sanctions are recorded in a dedicated book. Though staff receive training in the use of physical restraint such intervention is only ever used if it is felt a young person is in danger of hurting themselves or others. Records indicate that challenging behaviour is normally managed by the use of

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Protecting children from harm or neglect and helping them stay safe

The home operates with an experienced staff team who are supplemented by staff from the company's own staffing agency. Staff are recruited via a well-established recruitment process that requires a comprehensive range of checks to be undertaken. All prospective staff also have to successfully complete a training programme before being appointed. New staff only assume their full responsibilities once they have successfully completed a full induction process and demonstrated their competence.

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Helping children achieve well and enjoy what they do

The provision is good. Respite visits to the home provide many young people with opportunities to broaden their experiences by participating in a range of social and recreational activities in both the home and the local community. The home has its own specially adapted transport to assist young people with mobility difficulties. Staff support young people in developing their interests and hobbies and will accompany them on activities such as swimming, country walks and trips to the cinema. Recreational facilities within the home are good and include a soft play area and sensory room. A specially constructed play area to the rear of the property has recently been improved by the introduction of a swing and trampoline.

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Helping children achieve well and enjoy what they do

As the home's resident group can change on a daily basis, key information cards have been produced to ensure that important information relating to the care of each young person is available in an accessible format. Although staff on different shifts are allocated to work with specific young people, shift meetings ensure they are conversant with the care needs of all those in residence. Staff monitor the well-being of each young person and there are effective communication systems in place to ensure that important information is shared between all interested parties including parents and social workers. Staff spoken with were clearly aware of the specific care needs of the young people being accommodated.

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Helping children achieve well and enjoy what they do

As young people are only accommodated for short periods, staff are not involved directly in young people's education, however, they frequently liaise with parents and school staff to ensure they can access their normal educational placements. 6 of 8 Inspection Report: SC389174

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Helping children make a positive contribution

The provision is good. The home has an effective admissions process that identifies those young people who would benefit from respite placements. Young people are expected to visit in advance of any placement. If it is felt a placement is appropriate, a detailed assessment is initiated that identifies their health, physical, social, educational, cultural and leisure needs. From the information received placement plans are developed that provide guidance on how these needs can be effectively met during their visits. Placement plans also record contact arrangements and identify any restrictions. Placement plans are regularly monitored and updated in response to changing circumstances. The views of young people, their parents and placing social workers are sought as part of the normal reviewing process. Any recommendations arising out of reviews are incorporated into the placement planning process. Staff will work with after care team members

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Helping children make a positive contribution

to develop effective transition plans for young people moving on to adult services.

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Achieving economic wellbeing

The provision is good. During their visits young people are encouraged to further develop their social and life skills. Although social and life skills training is tailored to the needs and capabilities of each individual, there is a realisation that, due to the complexity of their disabilities, many will continue to require assistance with some daily living tasks including personal care. Staff are clearly aware of the vulnerabilities of each individual and risk assess all training activities.

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Achieving economic wellbeing

The home is specifically designed and equipped to meet the care needs of young people with disabilities. There are an appropriate number of spacious toilets and bathrooms. Each young person is provided with their own room that is furnished, in advance of any visit, to meet their specific care needs. There are a number of communal areas that include a lounge and dining room. The home is subject to regular maintenance and health and safety risk assessments. A tour of the building indicated that the home is structurally sound and in good decorative order.

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Organisation

The organisation is good. The home has a comprehensive Statement of Purpose that accurately reflects the nature of the service on offer. The Statement of Purpose is regularly updated to reflect changes in the way the service operates. A young person's guide has also been produced in a pictorial format for young people with communication difficulties. Young people are supplied with a guide as part of the admissions process.

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Organisation

The deployment of staff is effective. Due to the often complex needs of young people staffing levels are maintained at a high level. Staff normally work with young people on a one-to-one basis. Staffing levels are continuously monitored and increased in line with changing need. For example, staffing levels are increased during the school holidays when the home is fully occupied. Each shift is managed by a shift leader who determines the role and responsibility of each staff member. Staff shifts overlap to ensure adequate time for staff to carry out thorough handovers. All external activities are subject to a risk assessment process to determine appropriate staffing levels. 7 of 8 Inspection Report: SC389174 The company has an effective recruitment process. Staff are recruited from across the community and the staff team consists of males and females of differing ages from a range of ethnic backgrounds. All new staff must complete a comprehensive induction programme and

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Organisation

demonstrate their competence before assuming their full duties. There is a culture of training and professional development within the staff team and an expectation that individuals will keep their knowledge and practice updated. Staff access regular training opportunities through the company's comprehensive training programme. Additional training is provided by external professionals. Records indicate that health professionals are often called upon to provide staff with information on specific medical conditions. Training is also provided for staff required to undertake any delegated health tasks. All the staff have either completed, or are in the process of completing, their National Vocational Qualifications at Level 3. There is a well established staff supervision and appraisal system. There are regular staff meetings and minutes taken.

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Organisation

Since the last inspection the home's manager has completed the registration process. Evidence indicates that the changes he has introduced have had a positive impact on the operation of the home. Staff have adapted well to the new procedures and working practices. For example, staff are now conversant with the new policy and procedures relating to the storage and management of medication and evidence indicates the system is working well. Staff are well motivated and are pro-active in seeking out imaginative ways of making young people's respite stays both stimulating and enjoyable. The home is subject to a number of internal and external monitoring systems that include monthly visits by another home's experienced manager. The monitoring system is working well and monitoring reports indicate that identified issues are dealt with within an appropriate timescale. The promotion of equality and diversity is good and

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Organisation

staff regularly provide opportunities for young people to experience a range of cultural experiences. There is an efficient recording system and all aspects of each young person's placement are well documented. Records examined contain recent and relevant information and are kept in an appropriately locked facility.

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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

There are no recommendations. 8 of 8 Inspection Report: SC389174

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