Children's Home run by London Borough of Southwark in Southwark

SC031479 Unique reference number 4 June 2010 Inspection date Peter Daniel Inspector Key Type of Inspection

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30 November 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: SC031479

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Brief description of the service

The home provides short-term respite care for up to four children who have learning disabilities.

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Brief description of the service

The home is situated in a quiet cul-de-sac street within walking distance of shopping, leisure, transport, health and social services facilities.

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Brief description of the service

The children’s respite unit shares the building with a similar facility for adults, but the services are kept separate by locked doors. The adult service is inspected separately. The service users of both units share the garden at different times and with separate access.

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Brief description of the service

The children’s unit has a large and well equipped soft playroom. There are four single bedrooms, two on the ground level and two on the first floor, including bathrooms, and a staff sleep-in room. There is also a kitchen, dining room, activity room, lounge, bathroom, toilets, and laundry and shower rooms on the ground floor.

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Summary

This was an unannounced, key inspection that evaluated all the national minimum standards. The unit has positive leadership. There is a stable, skilled and experienced staff group. Many have worked at the unit for a number of years and bring a continuity of practice. Children receive excellent, child-centred care. Staff have a holistic approach which encompasses all aspects of the child's care, including health, education and emotional and behavioural development. Each child's progress is reviewed on a regular basis. Parents are fully involved in agreeing all aspects of the short break plan. The relationships between staff and children are very positive and there is a good atmosphere within the home. Staff are skilled in the different methods of communication and suitable means are provided for children with communication difficulties to make their views known. The home has effective safeguarding procedures in

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Summary

place, as well as administrative and monitoring systems. All the minimum standards are met exceptionally well. There are no breaches of regulations. The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The previous inspection report included a recommendation that staff working in the respite unit should receive regular, formal supervision. This is now being offered every four to six weeks.

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Helping children to be healthy

The provision is outstanding. The unit promotes the physical, emotional and health needs of each child and takes action as appropriate to meet them. Each child has a health plan that is included as part of the care plan. The unit keeps details of the child's health and emotional and behavioural development. Files show evidence of a child's profile, medication sheets, seizure observation charts and care plan. Each child has its health needs reviewed at the statutory review. 4 of 8 Inspection Report: SC031479 Children enjoy healthy, nutritious meals that meet their dietary needs. They are given opportunities at a resident's meeting to state their food preferences. Fresh fruit and vegetables are available as part of their diet. The unit caters for different cultural tastes.

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Helping children to be healthy

Parents retain responsibility about health matters concerning their child. Staff, nevertheless consult with parents about the child's health needs. The respite unit has a link with a local general practitioner.

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Helping children to be healthy

Staff undertake induction training and understand their role regarding the administration of medication. There are procedures for the recording and signing of medication which is double checked and signed by two staff. Medication is stored in a locked cupboard in the office. The home has guidelines for managing seizures, rectal diazepam and buccal midazelam. A senior residential care worker takes a lead role for medication.

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Helping children to be healthy

Overall, although the children only stay for short-term breaks, the staff are trained and clearly give priority to the child's health needs.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. The unit has procedures for safeguarding and promoting the welfare of the children. Staff understand their role and responsibilities in relation to protecting children and reporting any concerns to the relevant authorities. A risk assessment, in respect of moving and handling and behaviour management, is undertaken for each child on admission. It is intended that these are reviewed every six months.

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Protecting children from harm or neglect and helping them stay safe

The recruitment of staff is done through the head office, which retains individual files. No new staff have been recruited since the previous inspection. The head office uses a computer system for undertaking Criminal Record Bureau checks and the respite unit has access to this information. There is a robust system for the renewal of Criminal Record Bureau checks. The unit undertakes a Warner style interview when interviewing applicants. The unit has a system for vetting visitors.

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Protecting children from harm or neglect and helping them stay safe

The unit has appropriate systems for managing behaviour and safeguarding children. These include procedures for undertaking risk assessments, monitoring bullying, recording and notifying significant incidents and events, monitoring additional measures of control and recording complaints. Children and young people with a high level of need receive one-to-one care. In these circumstances, the unit might decide to reduce the number of children staying for respite (a system known as 'voids') so that staff are released to provide individual care to these children. Since the last inspection there have been no notifications.

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Protecting children from harm or neglect and helping them stay safe

The unit has a complaints system and parents know how to access the procedure on behalf of their children. Staff communicate with the children verbally or through a range of communication systems. A key worker is available to represent the child. Since the last inspection, there has been one unsubstantiated complaint that was investigated and signed off within timescales.

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Protecting children from harm or neglect and helping them stay safe

Staff are encouraged to assist children to develop socially acceptable behaviour. This is achieved through providing safe and consistent boundaries. Observation of relationships between staff and children illustrate that they are exceptionally positive. Staff show sensitivity, patience and understanding. Children with a high level of need, or challenging behaviour, benefit from the 5 of 8 Inspection Report: SC031479 intensive care. The use of physical restraint is rarely used and none has been applied since the last inspection. Staff are encouraged, instead, to use de-escalation and calming techniques. This includes talking to the child, calming them down or using quiet time.

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Protecting children from harm or neglect and helping them stay safe

Staff will soon undertake refresher training in safeguarding. Further training booked for this year includes first aid, food hygiene and moving and handling.

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Protecting children from harm or neglect and helping them stay safe

The unit ensures that steps are taken to keep residents safe from hazards within the building. Monthly safety checks are undertaken. Fire drills are done monthly, including evening and night time drills. A fire inspection is done annually and the unit has a certificate of conformity. Hoists are checked annually. Bedrooms have door monitors and sound activation units to monitor the children when they get distressed at night. The unit has a locked door policy for the safety of users. The building and garden are kept secure with entry and exit strictly controlled.

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Protecting children from harm or neglect and helping them stay safe

The unit protects children's privacy. Bedrooms toilets and bathrooms can be locked but over ridden if necessary. There are quiet areas where a young person can go for privacy, such as their bedroom, dining room or play room.

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Protecting children from harm or neglect and helping them stay safe

All the key national minimum standards in relation to safeguarding outcome are met exceptionally well. Children receive individualised care and staff give priority to their well-being and keep them safe. There are comprehensive systems in place to ensure this happens.

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Helping children achieve well and enjoy what they do

The provision is outstanding. The staff provide back up in supporting the parent in promoting the child's social and educational development. All children are given individualised support in line with their needs, either through 1:1 relationships with staff, through the key worker system and/or with other staff. The key worker acts as a point of contact with parents and schools. Support is also provided for children who need to use alternative methods of communication. For children who have communication difficulties, the staff support their learning through a range of communication systems to meet individual need.

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Helping children achieve well and enjoy what they do

The staff maintain the continuity of the child's education and attend reviews at school and support the child with their homework, where this is appropriate. Children are also seen at school as part of the admissions procedure to the respite unit.

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Helping children achieve well and enjoy what they do

During their stay, children are encouraged to take part in leisure and recreational activities. Children visit museums and parks, take part in day trips and attend a local club for people with learning difficulties. Children also have access to the play area in the garden. They also participate in indoor activities such as soft play, music, computer games and painting. Last summer, the unit successfully ran a play scheme that provided residential care and a day scheme. The children did lots of activities. The unit also plans to hold a summer fun day in July.

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Helping children achieve well and enjoy what they do

The unit has been innovative in organising short breaks combined with activities. The summer play scheme was able to provide families with access to more places for respite breaks. The unit plans to organise a repeat play scheme and outreach service this summer. 6 of 8 Inspection Report: SC031479

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Helping children make a positive contribution

The provision is good. Children are admitted in a planned way and a lot of care goes into introducing children to the unit. The staff first offer the family a visit and invite the child to come to tea. It might then take three or four similar visits, including an overnight stay, before a decision is made. The staff also visit the child at school.

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Helping children make a positive contribution

The unit has developed positive communication with the children and consultation with the parents. No child is deemed unable to communicate his/her wishes and feelings and staff talk to children using communication techniques. Children attend a resident's meeting where they are invited to contribute their views about their stay.

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Helping children make a positive contribution

Since each child attends the unit for short breaks, contact with his/her family is not a priority. Family members are however able to visit or phone if they wish. The key worker is responsible for maintaining links with the child's family and liaising with parents about the child's needs.

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Achieving economic wellbeing

The provision is good. Staff support the parent's role in preparing their child towards the transition to adulthood. Young people are supported in learning appropriate independent living skills such as self care, tidying rooms, preparing lunch and doing the laundry.

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Achieving economic wellbeing

Children enjoy homely accommodation, decorated and furnished to a good standard and providing good facilities. Four of the five bedrooms are being used. There is a new downstairs bedroom at ground floor level that allows for disabled access. In addition, there is bathroom, dining room, living room and soft play room, all comfortably furnished and decorated to a good standard. The kitchen is reasonably equipped and is to be re-furbished in the next financial year. There are three toilets with locks that one can be overridden. There is a spacious garden that is a suitable area for play. The building is purpose built for children and young people with disabilities. The bathroom is equipped with a hoist and there is disabled access to the unit. The building has sufficient space to meet the needs of the children.

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Organisation

The organisation is outstanding. The unit has an up to date statement of purpose. Staff are sufficient in number, experience and qualifications. The unit is fully staffed, except for one vacant residential care worker post. Agency staff are deployed to cover gaps, as necessary. There is always a minimum of two staff on shift at any one time. Overnight cover consists of one waking night staff and one sleeping staff.

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Organisation

The staff group is extremely stable and many have worked at the unit for a number of years. This has provided continuity in meeting the child's needs. There have been no changes of staff since the last inspection.

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Organisation

Staff have substantial, relevant experience and have done training that equips them with the skills to provide the excellent care that is offered. The majority of the staff have done National Vocational Qualifications at level 3 training or equivalent. Some have higher qualifications. 7 of 8 Inspection Report: SC031479 One staff member is currently completing NVQ training. Staff, in addition, have been offered in-house training during the past year that has included mental capacity, risk assessments and equality and diversity. All staff have done Makaton and Picture Exchange training. Further training is booked for this year as mentioned under Staying Safe.

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Organisation

Staff receive formal supervision every four to six weeks and have an appraisal every six months.

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Organisation

Regulation 33 visits and reports are being done routinely and the care of children is monitored and adapted in light of this information. The home intends to get feedback from parents when it holds a fun day in the summer. Children are reviewed twice a year as part of looked after procedures.

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Organisation

Each child has a secure record of their progress. Files, containing the records of children, are in excellent order and include the following information:- a service user profile, referral checklist, risk assessment, medication sheets, seizure observation chart, information sheet, a list of independence skills, school report and a care plan.

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Organisation

The unit's approach to diversity is outstanding. The service has equal opportunities and anti-discriminatory policies, the gender and ethnic balance of the staff team reflects the community it serves, every child is encouraged to communicate through the use of communication techniques, food menus are culturally sensitive and there is disabled access to the building.

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Organisation

Overall, the stability and experience of the staff group means that children are receiving excellent individualised care and support. There are no breaches of regulations or national minimum standards in relation to this outcome.

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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: SC031479

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