Children's Home run by Nottingham City Council in Nottingham

SC034900 Unique reference number 1 September 2010 Inspection date Rosemary Chapman Inspector Key Type of 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 10 Inspection Report: SC034900

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Brief description of the service

This service provides residential short-stay care for up to 11 young people with learning and physical disabilities aged eight to 19 years old. The home accommodates the young people in two units; the seven-bedded unit caters for young people with learning disabilities, and the four-bedded unit supports young people with physical disabilities or able-bodied young people who require a quieter environment.

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Brief description of the service

The home, which is run by a local authority, is located in a residential area close to the city centre, which facilitates easy access to a wide range of resources and promotes community inclusion.

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Brief description of the service

Eleven young people were using the service at the time of this inspection and most of them contributed in some way to this inspection. A number of surveys were received from parents, carers, young people and social workers, which also informed this inspection.

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Summary

This was a key, unannounced inspection which focused on all the Every Child Matters outcome areas and organisation. It found that the home continues to provide a good service to the young people, and has particular strengths in enabling young people to enjoy and achieve and make a positive contribution. Parents and carers value the support that the home provides and commented: 'It is a fantastic and invaluable service' and 'staff go the extra mile'. They said: 'The home is a fantastic place which offers a very important form of independence for a vulnerable child with special needs. Parents can have peace of mind knowing their child is safe and happy in a very friendly environment.'

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Summary

Young people's health needs are well met, they are kept safe and their well-being is promoted in all respects. Young people enjoy their short stays and take part in a lot of different activities when they are there. Their views are paramount and they are encouraged to contribute to their support plans and reviews, as well as aspects of how the home is run. The staff team show great commitment to providing good support and receive a good level of relevant on-going training and good managerial input to enable them to do so.

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Summary

The weaknesses identified do not generally impact on the care and support given to young people and relate to aspects of recording and documentation. 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 was identified at the previous inspection which related to holding four fire drills a year, including one fire drill at night. This has been achieved.

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Helping children to be healthy

The provision is good. Young people's health needs are well met in a variety of ways. They are provided with a varied and nutritious diet, which takes into account their likes, dislikes, and cultural, religious and 4 of 10 Inspection Report: SC034900 dietary requirements. Information about food preferences and requirements is obtained during the admissions process and this is clearly detailed in the residential action plan and passed on to the cook. However, alternatives to the menu are not currently being recorded in a consistent way which makes it difficult to monitor that individual requirements in relation to nutrition are being fully met. Young people have opportunities to prepare food for themselves. They have access to the kitchen with staff supervision and can make their own breakfast and Sunday tea as well as taking part in other cooking activities. They are given clear guidance through a traffic

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Helping children to be healthy

light system in relation to which are more healthy foods, to encourage a better awareness of healthy choices and thus promote their good health.

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Helping children to be healthy

Many of the young people have complex healthcare needs. Staff at the home work in close partnership with families and designated medical personnel to ensure continuity of care during the stay at the home. They receive appropriate training from community nurses to ensure they are competent to undertake complex medical procedures to a safe and satisfactory standard. One parent commented that her child was 'healthier and happier' due to the support from the home.

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Helping children to be healthy

The home has appropriate written policies and procedures which relate to all aspects of medication administration, including non-prescribed medication. Where errors have occurred, these are reported and action taken to minimise the risk of a reoccurrence, to promote safe practice. The medication room in the four-bedded unit is warm, but no thermometer is available to check that the room is of an appropriate temperature to store medication, and there is no record of the temperature of the refrigerator which is used to store medication which requires refrigeration. This may compromise the effectiveness of the medication stored. There is always a member of staff on duty who has first aid training so young people receive appropriate help in an emergency.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people's privacy is respected as far as possible and staff demonstrate sensitivity and a strong awareness of the need to balance safety and security with maintaining appropriate privacy, particularly when a young person needs a lot of assistance with personal care. The complement of staff means that same gender care can be given where possible and appropriate. A range of relevant policies and procedures are available to guide staff practice and ensure consistency.

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Protecting children from harm or neglect and helping them stay safe

Young people know how to complain if they are unhappy about any aspect of their care. An appropriately written procedure is in their welcome pack and posters are on display which inform them about the advocacy service. An independent advocate visits the home regularly so that young people get to know them and feel more comfortable to express their views. Any complaints made have been addressed appropriately by the manager.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected from abuse because staff have easy access to the home's policies and procedures, they have regular training which informs them about how to respond to any allegations and there are good links with the local authority designated officer, who gives appropriate advice. Young people say they feel safe in the home.

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Protecting children from harm or neglect and helping them stay safe

Bullying is seen as unacceptable and although there are occasional instances, these are dealt with appropriately. All young people have risk assessments which address bullying, both from 5 of 10 Inspection Report: SC034900 the risk of being a bully and also a victim. These give clear guidance to staff so that they are aware of the risks and likely instances when bullying may occur, so that they can reduce the risk.

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Protecting children from harm or neglect and helping them stay safe

Young people occasionally wander off, rather than deliberately go missing. Staff are very aware that the young people they care for are very vulnerable so there are clear and prompt reporting procedures when this occurs to protect them and ensure their safe return as soon as possible.

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Protecting children from harm or neglect and helping them stay safe

Staff have clear guidance about how to respond to young people's negative behaviour and are appropriately trained in physical intervention techniques. Instances when physical intervention is used are rare but these are fully recorded in a book, the pages of which are numbered manually. At the time of the inspection, the pages were not fully numbered and this could lead to pages being torn out to prevent proper monitoring. Sanctions are not used on a regular basis as staff are very aware of young people's behaviour triggers and use distraction techniques effectively to prevent incidents occurring.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected from environmental hazards and live in a home that is safe and secure. Any activity or potential hazard is risk assessed and action taken to eliminate or minimise the risk. Gas and electrical installations are serviced and maintained appropriately, as is the fire equipment. Regular fire drills take place so that staff and children know what to do in the event of a fire, and this now includes at least one drill at night in a 12-month period. However, there is no evidence of appropriate insurance cover.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected from being exposed to potential abusers through rigorous checking of staff and close monitoring of visitors. All staff are interviewed, references are taken up and Criminal Records Bureau checks are updated every three years. All visitors have to show proof of their identity and sign the visitors' book before being allowed entry to the home, and they do not have unsupervised access to children.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people receive outstanding individual support to enable them to enjoy and achieve to their full potential. The residential action plans contain a section which is written as far as possible with the young person to identify what they want to achieve during their short stays, and what their interests and aspirations are. Short stays are arranged where possible with the needs of the social group in mind, to facilitate friendships. A variety of communication systems are used to enable the young people to express their views and communicate with staff. An independent advocacy service is involved with the home and an advocate visits regularly as another avenue for young people to raise concerns or express their feelings.

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Helping children achieve well and enjoy what they do

Young people continue with their education during their short stay. There are clear arrangements for transport to ensure they can attend their usual school and thus not have any disruption to their education. There are close and effective links between key workers and the varying schools which young people attend; staff from the home and school are involved in all reviews and there is good communication. Key workers undertake both a home and school visit before updating the residential action plan. If young people have schoolwork to do during the short stay, staff help with this, for example, helping a young person to learn a certain number of words. There are also computers with internet access which young people can use to either assist with school work, or use more generally. 6 of 10 Inspection Report: SC034900 The opportunity for young people to engage in a variety of leisure interests is a particular

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Helping children achieve well and enjoy what they do

strength of the home. Staff are very aware of particular interests and parents commented that staff often engage with young people about their special interests. These are clearly detailed in the residential action plans. Young people have had a variety of trips and holidays, and photographs are on display as a reminder of these. This inspection was undertaken during the school holidays and young people went on different pre-arranged trips during the two days. Young people are also encouraged to take part in the Duke of Edinburgh award scheme so they have a tangible reward for their efforts and their self-esteem is promoted.

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Helping children make a positive contribution

The provision is outstanding. There is an outstanding assessment of young people's needs within the residential action plan. These plans are very thorough and detailed and include all identified needs including those pertaining to religion and culture. The level of detail is important to ensure continuity of care for young people who are usually cared for by their parents or other carers, and also for those young people who are on the autistic spectrum who find it difficult to cope with change. Key workers use all available information to make the residential action plan a working and meaningful document. This includes home and school visits. It is also very clear that young people play an integral part in drawing up the plan, which is very person-centred.

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Helping children make a positive contribution

Young people are encouraged to contribute to their reviews and even if they do not attend in person, they complete a form which is written in an appropriate format.

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Helping children make a positive contribution

Young people usually stay at the home for a period of three days at a time, so although they are able to maintain contact with families and friends if they wish, the break is usually seen as a time to be away from usual contacts. However, staff at the home will contact the family if there are any issues, young people may phone if they want to, and families may visit.

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Helping children make a positive contribution

There are excellent procedures for introducing young people to the home. Prior to short stays being agreed, young people have a core assessment which is considered by the multi-agency resource panel, chaired by the Registered Manager of the home. This looks at all the services a young person and their family may access, of which this service is one. Thus families are able to choose what best meets their needs and may use a number of services. Once they decide to access this service, there is a clear admission process which includes the key worker being allocated, meeting the child and family, devising the residential action plan and introductory visits. One parent commented: 'There was very good preparation prior to admission'. This ensures that a young person settles more easily, enjoys and benefits from the break and has their needs met in a consistent manner. When booking short stays, the home takes into account

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Helping children make a positive contribution

the needs of all the young people at that time, so they have a good and appropriate mix.

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Helping children make a positive contribution

The opportunities for young people to make a positive contribution are excellent. Their opinions are seen as very important and every effort is made to elicit these using a variety of techniques. There are regular recorded young people's meetings as well as informal and formal key worker sessions. Young people have influenced the food, the activities, and the purchase of the computer. After each short break, families are provided with a feedback form so they can say what worked well and what could be improved. This is in addition to more formal quality assurance processes which occur on a two-yearly basis. Young people are encouraged to contribute to the community where the home is located and have been involved in improving leisure facilities in the area. They also have an allotment. Some of the young people are involved 7 of 10 Inspection Report: SC034900 in influencing the wider council through their appointment as MPs in the youth parliament.

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Helping children make a positive contribution

This is outstanding practice and shows the value the staff at the home place on the young people's views. The young people are also encouraged to be involved in giving to charity, rather than always being recipients, and every year they choose a charity for which to fundraise. This links into maintaining a healthy lifestyle as many aspects of fundraising involve physical activities.

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Achieving economic wellbeing

The provision is good. The home works in partnership with parents, carers, schools and the transitions team to ensure there is a smooth transition to adult services and college placements. Key workers ensure that the other professionals involved are fully aware of the young person's needs and wishes, based on their extensive knowledge of the young person, often gathered over a number of years. Any relevant records are shared, with the young person's permission, to promote consistency of care. Workers from the home will also go to new placements with the young person and their parents and carers to provide support and information. Because the home provides short breaks, parents and carers have the primary responsibility for promoting a young person's independence. However, this responsibility is also shared by staff at the home who facilitate opportunities such as cooking, laundry and shopping to promote independence.

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Achieving economic wellbeing

The home is purpose-built and accommodates up to 11 young people at any one time, in units of seven and four respectively. The four-bedded unit has en-suite facilities and has been adapted to provide suitable facilities for young people with a physical disability. Young people are allocated the same room when they come to stay where possible, and on admission, the bedroom door has their name and photograph on it to make it more personal for them. The accommodation has been made as homely as possible, and is suitable for the young people's needs, particularly as they only usually stay for three days at a time. There are spacious communal areas to facilitate activities and provide separate, more private space for others. All the bedrooms are single and have alarms fitted which can be used to promote safety and security where necessary. Young people are able to lock their bedroom if they wish to do so. There is a play

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Achieving economic wellbeing

area surrounding the home which includes a trampoline and other suitable play equipment. Although there is not a phone for the exclusive use of young people, they can use the office phone should they wish to do so, or they have their own mobile telephones.

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Organisation

The organisation is good. The home has a Statement of Purpose which was updated in July 2010. This provides very clear and relevant information about the home and the services it provides so that parents, carers and other relevant people are fully informed and know what they can expect from the home. Children and young people are provided with similar information in the form of a children's guide, which is written in pictorial form to aid their understanding.

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Organisation

Children are cared for and supported by a very competent staff team and clear arrangements for managerial oversight and support. The Registered Manager is supported by assistant unit managers and each shift has an identified shift leader, to ensure there are clear lines of responsibility and accountability. The majority of staff at the home have been in post for a number of years and have substantial experience in caring for children with disabilities and complex needs. Not only have staff got substantial experience, they are also well qualified, with 96% having at least a National Vocational Qualification at level 3 or above, or an equivalent 8 of 10 Inspection Report: SC034900 qualification. This ensures that children receive good support which meets their identified needs.

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Organisation

Staffing levels are good, both during the day and at night time which ensures there are enough staff on each shift to respond to young people's individual needs. The staff team is stable, and any shortfall is met through the use of a small number of relief staff who are well known to the children and the home. This ensures consistency of care and a minimum level of disruption to young people, some of whom do not cope well with change and uncertainty. They know who is on duty as the names of staff are written on a board in each unit, and staff photographs are also on display to aid identification. The staff team comprises both males and females so that same gender care can be provided, and they also represent a variety of cultures which reflect those of some of the service users.

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Organisation

Staff are able to access a good level of training to ensure they can meet the varying needs of young people using the service. They have four days as a whole staff team to ensure that all mandatory training is up to date; in addition, they access individual courses as identified on their annual appraisals.

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Organisation

There are good systems in place for monitoring the home to ensure the service provided to young people is effective. Regulation 33 visits are carried out and thorough reports of these visits are sent to Ofsted as required. Reports which are carried out in line with regulation 34 identify shortfalls and actions. However, the records are only signed every two months, rather than every month, and not all the records detailed in Schedule 6 are examined. Although this does not have a significant impact on the well-being of young people, it does not meet the requirements of the national minimum standards.

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Organisation

Each young person has a permanent, private and secure record of their history and progress and they are encouraged to contribute to this.

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Organisation

The promotion of equality and diversity is outstanding. Young people are treated as individuals and all their care needs are identified and met, including those relating to culture and religion. Community inclusion features highly and all the young people are encouraged to contribute their views to all aspects of their care. Care planning is person centred, and the young person's views are paramount in terms of what they want to achieve from their stay at the home.

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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

29 October 2010 make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the home, with particular reference to the temperature of the medication room and refrigerator. (Regulation 21(1)) 9 of 10 Inspection Report: SC034900

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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 there is a record of the menus as actually served so that individual requirements can be monitored (NMS 10.4) • maintain a record of restraint in a bound and numbered book book dedicated for that purpose (NMS 22.9) • ensure there is current Public and Employee Liability insurance and the certificate specifies the name and address of the particular home (NMS 26.9) • ensure the home's records are monitored and signed once a month by the registered person. (NMS 33.1) 10 of 10 Inspection Report: SC034900

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