Children's Home run by Liverpool City Council in Liverpool

SC035969 Unique reference number 9 July 2010 Inspection date Michelle Moss Inspector Key Type of Inspection

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8 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 8 Inspection Report: SC035969

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Brief description of the service

The children's home provides short-term breaks and respite care for boys and girls between the ages of eight and 19 years. The home cares for up to seven young people with learning disabilities and physical disabilities at any one time. Many of the young people use non-verbal methods of communication. The home is a purpose-built detached property, within easy distance of local parks, cinemas, shops and schools.

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Brief description of the service

At the time of the visit there were seven young people accessing the service and all were met.

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Summary

This was a key unannounced inspection that has looked at all the Every Child Matters outcome areas. The home is meeting the vast majority of the national minimum standards, resulting in young people receiving enhanced care in nearly all regards. The home is well managed and well staffed. There are good relationships between the staff team, the young people and their parents/carers. Families describe the service as 'brilliant' and know their children have the support of a dedicated and enthusiastic staff team that ensure care is tailored to meet their individualised needs. The rapport between young people and staff is built on mutual respect with young people's families having confidence in their carers' abilities.

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Summary

Previous shortfalls have been addressed with the result that staff are more aware of conditions such as autism. Also, staff now have access to copies of young people's statements of special educational need and better recording systems. However, there are some minor new shortfalls that have arisen from this inspection. These relate to countering bullying, risk assessing, record keeping and some minor gaps in training. Despite these new shortfalls, the home's strengths outweigh the weaknesses, especially in the child-centred care provided and the level of enjoyment seen by young people who access the service. 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 is ample evidence of good progress being made by the home to address previous shortfalls. This includes the home introducing a dedicated log book for recording complaints. Also, the bound book used for recording physical interventions is now page numbered and dated clearly. As a consequence, there is greater transparency over practice to show the welfare of young people is safeguarded. However, there are still occasional records that fail to clarify the length of the physical restraint.

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Improvements since the last inspection

Steps have been taken to obtain copies of young people's statements of special educational need. These are helping staff to be better informed about young people's additional needs. The staff have received autism awareness training which has meant they are better informed about how different children can be affected by the condition.

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Helping children to be healthy

The provision is good. 4 of 8 Inspection Report: SC035969 Key information about health needs are gathered from families and professionals and used by staff to ensure young people's well-being is promoted. This information is then clearly recorded and utilised by a skilled staff team to ensure individual health needs are fully met. To ensure staff are skilled to meet young people's diverse needs, staff receive training. For example, training has included awareness of epilepsy, autism, first aid and gastrostomy feeding. Clear procedures are followed for the management, secure storage and administration of medication, including obtaining parental consent for administering medication and first aid. However, first aid boxes are not sufficiently stocked to ensure they remain fit for purpose.

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Helping children to be healthy

The staff have a clear understanding around respecting cultural identity and diverse needs through the provision and preparation of meals. The training undertaken by staff has equipped them with the acquired skills necessary to meet individual dietary needs, including any specialised feeding requirements. Meals are set up to be a relaxed and social occasion.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Staff are sensitive to young people’s needs and promote their privacy and dignity at all times. There is an effective complaints procedure, which is available in formats understood by young people with learning disabilities. The staff use a range of communication aids that empower young people to make decisions including expressing concerns.

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Protecting children from harm or neglect and helping them stay safe

Arrangements for safeguarding young people are good. There are comprehensive procedures in place to ensure the vetting of staff and monitoring of visitors are thorough. This includes all staff having their Criminal Records Bureau checks periodically repeated and all visitors being required to sign in and out of the home. In addition, all care staff are provided with child protection and safeguarding training, which they apply in the practices to protect the welfare of young people. However, the same training is not offered to ancillary staff.

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Protecting children from harm or neglect and helping them stay safe

The care staff understand their responsibilities to safeguard and promote the welfare of young people. There is also recognition of the importance of maintaining vigilance to ensure young people feel and stay safe. However, anti-bullying practice is not interwoven into behaviour management. There are no detailed risk assessments on countering bullying and staff have not been afforded specific training that helps them recognise links between behavioural traits and potential bullying. As a consequence, early intervention for countering bullying is limited.

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Protecting children from harm or neglect and helping them stay safe

There are good procedures for ensuring the correct people and authorities are informed about any notifiable event. Nevertheless, there has been at least one occasion where the home has not followed their procedure as rigorously as required to ensure all authorities have been informed.

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Protecting children from harm or neglect and helping them stay safe

A clear threshold based on risk is applied when physical intervention is necessary. A hierarchy of techniques for physical intervention takes account of the young people’s age, disability and the seriousness of the situation at any given point. Behaviour management plans are devised for each young person and are informative about when physical intervention should be considered. The support given by care staff enables young people to stay safe and self-manage their behaviour. This avoids behaviour escalating to a level whereby young people become distressed and place themselves and others at risk. Because of this effective approach, the use of restraint in the home is only used as a last resort. However, there are occasional inconsistencies in recordings making it difficult to ascertain the accurate period of when restraint 5 of 8 Inspection Report: SC035969 was directly applied. This hinders having an accurate record to validate any restraint is for the

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Protecting children from harm or neglect and helping them stay safe

There is a strong commitment to securing young people's physical safety and security. This includes having specialised medical equipment easily accessible, all of which are regularly tested and serviced to ensure they remain fit for purpose. There are clear records made to evidence regular fire drills and testing of fire equipment are maintained. Hot water accessed by young people is checked to minimise the risks of scalding, although the frequency between checks varies. All staff are trained in the safe moving and handling of young people and have access to assessments that reflect the level of support required to safeguard each person's welfare.

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Protecting children from harm or neglect and helping them stay safe

The home has not had a young person go missing from care. Nevertheless, procedures are in place that cover the action staff would be required to take in the event a young person going missing. These procedures take into consideration the vulnerability of young people and the required response to secure their safe return.

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Helping children achieve well and enjoy what they do

The provision is good. Parents and carers say that their children love their short breaks, which is evident in their excitement when they know a stay is due. During stays, young people experience an extensive range of activities including access to sensory facilities, parks and other leisure facilities. The staff have established links with schools attended by young people to help maximise learning opportunities and to help young people aspire. In addition, the home obtains a copy of each young person's statement of special educational need. The staff use this additional information to help them to be increasingly informed about young people's developmental needs. Care plans also provide a good resource to help staff to identify young people's individual needs, including those relating to disability, race, culture, language and beliefs.

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Helping children make a positive contribution

The provision is good. There is a wonderful rapport between young people and staff that is mutually respectful. This strong relationship makes young people feel relaxed, comfortable and confident around staff and in using all the facilities offered by the home. Close, effective liaison between the staff, schools and families promotes a shared understanding of young people’s needs and secures a consistent approach in care. These established links help the staff to formulate an informative placement plan that is made up by a number of documents that provide some valuable insight into the needs of young people. Areas such as spiritual and cultural needs are captured throughout the documents including recognising young people's heritage. The plan once established is closely monitored by a key worker within the home who ensures the plan reflects the day-to-day care of the young person. However, some elements of assessing the needs of

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Helping children make a positive contribution

young people are not sufficiently detailed to risk assess all aspects of welfare. For example, behavioural plans do not always adequately reflect the level of supervision and support a young person needs to match their behavioural traits. This in turn creates a level of confusion between staff over whether young people require one-to-one supervision and what this actually means in practice. Another example is that the home is not always assessing the hazards associated with the major refurbishment against the individual behaviours displayed by young people. 6 of 8 Inspection Report: SC035969 Essential information is gathered by a key worker from families and then shared with the team prior to admitting a young person for a series of short-term breaks. The young person’s introduction to the service is planned carefully and sensitively with introductory and tea visits arranged so that the young person can get used to the new environment and the staff. Equally,

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Helping children make a positive contribution

when young people are moving on from the service, this is managed with the same level of careful planning and respect of young people's changing needs. When young people are due to leave, the staff make sure it is made into a special occasion with parties and meals out.

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Helping children make a positive contribution

There are regular young people's meetings that enable them to contribute to decisions about their stays. These meetings often focus on the activities and facilities. For example, young people have raised matters in the past such as requesting a driver is available on each shift and also asking for a more up-to-date television. The management have listened to these comments and actioned them. This shows how young people are being positively empowered to influence decisions that directly affect them.

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Achieving economic wellbeing

The provision is good. The service is specifically tailored to provide short breaks for young people with various disabilities. The home is equipped with the required aids and adaptations to reflect the diverse needs of young people choosing to use the service. The home supports many young people whose parents are having difficulties with their behaviour and the staff offer a service to the young people that allows them to enjoy a short break, while also supporting their family.

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Achieving economic wellbeing

The ground floor of the building is in the middle of a major refurbishment, including adding a second living room, to allow for greater space to be offered to meet the diverse needs of the young people.

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Organisation

The organisation is good. From the Registered Manager right through the staff team, there is a shared commitment to providing a high quality short-break service for young people with learning and physical disabilities. The staff are suitably qualified to match their roles and responsibilities. The staffing levels are managed in a way that ensures young people receive tailored support when they need it. However, some elements of supervising young people can on occasions be slightly fragmented so that rigorous supervision is not always sustained. Regular staff meetings and supervision are seen as a key element of maintaining the quality of care and to ensure young people are safeguarded. This includes practices being evaluated by management to ensure the needs of young people are continually met.

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Organisation

A good range of internal and accredited courses are made available to care staff, including first aid, care of medicines and safeguarding. These courses help them gather the required knowledge to keep children healthy and their welfare enhanced. However, ancillary staff are not offered the same training opportunities in areas of child protection and safeguarding. This limits having the same level of understanding about protecting young people from abuse and applying safeguarding in practice.

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Organisation

The management team monitor and sign appropriate records as part of their internal quality assurance. Regulation 33 visits take place monthly and provide an additional quality assurance 7 of 8 Inspection Report: SC035969 mechanism. The findings of these visits are captured in a written report that is sent to the home in a timely manner. This information is then used by the Registered Manager to drive forward improvements in the quality of care for young people.

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Organisation

The promotion of equality and diversity is good and is captured in the ethos of the home and embedded in practice. The management recognises that equality and diversity play an integral part of care and support.

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Organisation

The Statement of Purpose is clear in setting out what care the home will offer young people and their families. For young people, a more child-friendly booklet is provided. This is attractive and well presented to take account of young people's different abilities, including the use of symbols and pictures to support the written text. Young people's files hold all details and documents set out under regulations. The vast majority of these documents are managed appropriately to ensure young people's confidentiality is not compromised. Nevertheless, some personal information about young people is kept in the lounge. Although this means young people can access information written about them, it also results in other people gaining access to their private information.

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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

6 August 2010 make sure all events that require notifying to Ofsted are sent in (Regulation 30(1) and Schedule 5) 6 August 2010 make sure written records made for restraints clearly record the actual duration of the restraint. (Regulation 17(4)(d))

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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): • keep young people's information adequately secure so that their confidentiality is protected (NMS 35.2) • offer ancillary staff child protection and safeguarding training (NMS 17.1 and 31.5) • carry out a risk assessment of the times, places and circumstances in which the risk of bullying is greatest. Offer staff awareness training on countering bullying and undertake risk assessments for individual young people when there is a potential risk for bullying, either within or outside the home (NMS 18.2, 18.5 and 26.2) • make sure first aid boxes remain fit for purpose (NMS 13.5) • make sure when assessing young people's needs that risk assessments are also undertaken that identify hazards that might impact on their and other young people's welfare including behaviour. (NMS 2.1 and 26.2)

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