Children's Home run by Dorset Council in Dorset

SC032163 Unique reference number 7 July 2010 Inspection date Stephanie Omosevwerha Inspector Key Type of Inspection

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22 September 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: SC032163

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Brief description of the service

The provision is a purpose built children's home that is run by a local authority. It is situated in a residential area of a seaside town. The site where it is based also accommodates a home for older people and a sheltered housing development. The home is able to accommodate up to 14 children and young people of either sex, aged between four and under 18 years of age who have a learning disability including those who have additional more complex or challenging needs. The majority of children receive respite care but the home is also able to support children requiring longer-term care. In addition the home provides a day care service for up to 10 children during weekends and school holiday periods. The home is arranged into four living units with a fifth area used for day care. Each unit has single bedrooms, bath and toilet facilities and lounge/diners. Two units have a kitchen. One unit has been specially adapted for children with

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Brief description of the service

physical disabilities. Other facilities include a sensory room and an art/craft room. The home is built around a quadrangle which is used as a play area and has additional garden areas around the outside of the building.

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Brief description of the service

There were eight children accommodated at the time of this inspection.

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Summary

The home provides a good standard of care to children with severe learning disabilities and services are particularly tailored to meet the needs of this group of children. The service is currently in a period of transition moving from providing respite care to more long term placements. There has been an increase of children who present more complex and challenging behaviours. Staff are well trained and confident in managing this group of children. There are excellent links with other agencies, such as health and education, enabling children to receive a consistent and well co-ordinated service. There has been excellent stability in the staff team enabling staff to get to know the children they work with well. Staff work closely with parents and build positive relationships. This means parents feel confident in the care their children receive. One parent commented, "I am happy and confident that my child's needs are met at

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Summary

Shortfalls identified at this inspection mainly relate to records and do not impact directly on children's care. These included updating the home's Statement of Purpose to reflect the recent changes and updating the fire risk assessment. 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 four recommendations made at the last inspection relating to behaviour management, staff fire training, staff supervision and appraisals. One recommendation had been fully met, one partially met and the two recommendations about staff supervision and appraisals had not been met and are repeated in this report.

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Improvements since the last inspection

Staff are clear about behaviour management and receive additional guidance from a multi-disciplinary health team who offer support with behaviours that challenge. Staff have received up-to-date training in de-escalation techniques and encourage children to behaviour 4 of 9 Inspection Report: SC032163 well by giving approval and using rewards rather than imposing disciplinary measures. Individual strategies that work best for each child are detailed in care plans and staff are confident about implementing these in practice.

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Improvements since the last inspection

There was evidence that some fire training had been carried out on two separate occasions, however, it was difficult to establish from records which members of staff had attended these events.

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Helping children to be healthy

The provision is good. Children enjoy healthy and nutritious meals that cater well to their likes and dislikes and specific dietary needs. Care plans contain detailed information about each child's individual requirements such as any allergies, preferred texture of food, and any specialist equipment needed to help children eat more independently. Catering staff are employed to prepare evening and weekend meals and staff are able to make additional snacks if necessary. Meal times are viewed as social occasions and staff encourage the development of children's skills at the table including promoting table manners, encouraging independent eating and joining in with preparations like laying and clearing tables. There are kitchen facilities in two units that enable older children to develop additional skills such as making drinks and snacks and washing up.

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Helping children to be healthy

Children's good health is promoted and plans clearly identify their physical and emotional needs. There is good provision for ensuring children who are long stay residents have their primary care needs met and staff ensure they attend all routine appointments, for example opticians and dentists. For children that are provided with a respite service the responsibility tends to remain with the parents or carers. Children benefit from additional services and there is excellent support from a multi-agency health team who regularly visit the home to provide support sessions, including individual work with children and guidance to staff.

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Helping children to be healthy

Children's wellbeing is safeguarded by good policies and procedures which ensure medication is effectively managed and administrated. Medication is kept securely and only administered by senior staff who are assessed as competent and demonstrate good understanding of children's medicines, including what they are for, any contra-indications and what to do in an emergency situation. Accurate records are kept of all medication and any treatment or first aid given to children.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Children's privacy is respected while maintaining the level of supervision and support necessary to ensure their safety. Staff are sensitive when offering personal care to maintain children's dignity and enable them to express choice wherever possible. There are clear guidelines in place on privacy and confidentiality to ensure staff are clear about their responsibilities in handling personal information. There is an open ethos and parents and carers are encouraged to raise issues with staff on duty so they can be dealt with as they arise. Staff work hard to listen to children with non-verbal communication to ascertain their feelings about the way they are cared for. There is a formal complaints procedure but no complaints have been made since the previous inspection. 5 of 9 Inspection Report: SC032163 Children are kept safe by clear procedures for responding to child protection concerns. Staff

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Protecting children from harm or neglect and helping them stay safe

are appropriately trained and understand their responsibilities to report any suspicions or concerns. There are excellent links with the local safeguarding board ensuring any concerns can be promptly dealt with. There is little risk of children going missing due to high staffing levels, which ensure children have the identified levels of support and supervision they need to keep them safe in the home and out in the community.

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Protecting children from harm or neglect and helping them stay safe

Children are encouraged to develop socially acceptable behaviour. Staff are trained in behaviour management techniques and have a good knowledge of children's individual behaviours including the most effective strategies to use. Staff work consistently and constructively to promote positive behaviour. Children benefit from additional multi-agency support provided to the home which can provide intensive intervention to individual children and advice and guidance to staff. Bullying is also dealt with through behaviour management strategies as the majority of incidents are not premeditated and may be linked to children's disabilities such as autism.

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Protecting children from harm or neglect and helping them stay safe

Children are provided with a secure and safe environment. A range of risk assessments are carried out to manage and minimise potential hazards to children both in the home and in the community; however, the fire risk assessment has not been recently reviewed. Regular checks and servicing of the environment and facilities ensure the premises are well maintained. Records for staff fire training do not provide clarity about the amount of training staff are currently receiving and it is difficult to identify any gaps in training.

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Protecting children from harm or neglect and helping them stay safe

Children are protected by stringent staff recruitment procedures that ensure all staff are carefully selected and vetted prior to working in the home. Staff are aware of their responsibilities to monitor and manage visitors to the home to ensure all children are kept safe.

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Helping children achieve well and enjoy what they do

The provision is good. Children receive individualised support and specific needs are identified on their care plans, such as those in relation to gender, disability, religion, culture and communication. Children who require additional services, for example health and education, have excellent access to these in practice including specialist workers who visit the home. Staff spend time getting to know children to ensure they can meet their individual needs. Staff training covers alternative forms of communication to ensure all children are actively listened to.

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Helping children achieve well and enjoy what they do

Children's educational needs are recognised and promoted. The home keeps accurate information about children's educational placements and develops strong links with schools to establish a co-ordinated approach to children's care. The home is currently working with one local school to produce a 24 hour curriculum to provide children with learning opportunities throughout the day. The home also uses similar styles of communication tools and approaches which enable children to receive consistency that promotes positive changes to their behaviour.

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Helping children make a positive contribution

The provision is good. Children's needs are clearly set out in well written placement plans outlining how their needs will be met in the home. Key workers regularly review care plans to ensure they provide latest guidance to staff working with the children. Statutory reviews are held at the required intervals and children are enabled to attend when they can to understand and contribute to the process. 6 of 9 Inspection Report: SC032163 Staff contribute effectively by providing written summaries of the child's progress and attending the review.

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Helping children make a positive contribution

Children are supported to maintain valuable contact with their families. Visitors are welcomed and are able to stay for tea visits or take their children out according to their preference. Good communication is established with families to ensure they are regularly updated about their children's well-being.

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Helping children make a positive contribution

Children are able to move into and leave the home in a planned and sensitive manner. Children who move in to the home often have the benefit of having respite stays prior to moving in permanently which enables them to establish good relationships with staff. Staff actively support children who are moving on and understand the importance of keeping links enabling children to continue to remain in touch and visit.

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Helping children make a positive contribution

Children are encouraged to have a voice and staff take time to listen, particularly to children who have communication difficulties, to ensure they are able to make choices in their daily lives. Good use of signs and symbols help children to understand daily routines in the home, such as meals, staffing and activities. Parents and other stakeholders recently had opportunities to contribute to service development and were encouraged to give their opinions about the refocusing of services towards long stay placements. This was confirmed by a parent who said "They are always prepared to ask my opinion on certain issues, which makes me as a parent, feel involved."

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Achieving economic wellbeing

The provision is good. Children moving towards adulthood are provided with appropriate planning and assistance. This involves supporting children through the transition from children's to adult services as most children continue to need support once they reach adulthood. Staff support children to undertake tasks with assistance according to their abilities, such as preparing drinks and snacks; however, as the home works with children with severe learning disabilities they are unlikely to move on to independent accommodation.

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Achieving economic wellbeing

Children are accommodated in well maintained facilities that are decorated and furnished to a good standard. There is suitable provision for children with physical disabilities as all facilities are on ground level and appropriate equipment, such as hoists and wheelchairs, is provided. The home is split into four separate living units so children can be looked after in smaller, more manageable groups. Each child has a single bedroom and there are plenty of communal facilities both indoors and outdoors to ensure children can enjoy a good range of recreational activities.

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Organisation

The organisation is good. A Statement of Purpose is in place covering all regulatory requirements, however, it has not been reviewed for over a year and needs updating to reflect current changes in the service which is now refocusing on more long stay placements. There is a simple guide for children to explain what it is like to live in the home. A member of staff is responsible for going through this with the children to help them understand the content. 7 of 9 Inspection Report: SC032163 The home is well managed with effective delegation of tasks throughout the senior management team to ensure the smooth running of the home. Shifts are well organised with staff being clear about their responsibilities. There is always a senior member of staff on duty to offer guidance and advice so staff feel well supported in their daily practice. However, there are gaps in staff's formal supervision sessions, that are not taking place at the recommended frequency.

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Organisation

Staff annual appraisals of performance are also overdue which does not give staff opportunity to reflect on their performance or to identify future development goals.

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Organisation

Children are cared for by a stable staff team who have a good mix of skills and experience. There has been an excellent improvement in the numbers of qualified staff which has contributed to staff feeling more confident and competent in their work with children, particularly those who present more complex behaviours. Staff have opportunities to undertake further training linked to the needs of children in the home, for example communication skills. Good staffing levels ensure children are provided with the care and attention they need.

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Organisation

The promotion of equality and diversity is good. Children have plans that reflect their individuality and staff have a good knowledge of each child's specific needs. Children with communication difficulties are supported by good use of alternative methods of communication, such as signs and symbols, to help children make sense of their environment. There is a mixed staff team enabling gender sensitive care to be provided where possible. Children have good access to the local community and are encouraged to access a range of amenities and facilities to promote social inclusion.

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Organisation

There is good provision for monitoring the home's overall operation and how it is performing in relation to outcomes for children. The manager regularly reviews all aspects of the service and identifies are areas where action needs to be taken. Monthly monitoring visits are undertaken by the responsible individual and provide an independent assessment of the quality of care.

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Organisation

Children's records are kept securely and provide an accurate reflection of their needs, development and progress during their time in 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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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure that the fire risk assessment is updated and reviewed regularly to reflect any changes in the premises. (NMS 26) • maintain accurate records of staff fire training so that the frequency of training can be accurately monitored. (NMS 26) 8 of 9 Inspection Report: SC032163 • review the Statement of Purpose at least annually to ensure it contains the most up-to-date information about the service, including the recent changes to the types of placements in the home. (NMS 1) • carry out supervision of all care staff at the recommended frequency of one session each month. (NMS 28) • ensure all staff have their performance individually and formally appraised at least annually by their line manager. (NMS 28). 9 of 9 Inspection Report: SC032163

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