Children's Home run by West Sussex County Council in West Sussex

SC399222 Unique reference number 13 July 2010 Inspection date Kevin Whatley Inspector Key Type of Inspection

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13 January 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 9 Inspection Report: SC399222

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Brief description of the service

The service aims to provide intensive programmes of care and support to up to three young people aged between eight and 11 on admission. Young people admitted to the setting will have a learning disability or complex needs such as autism. The nature of the service means that a majority of placements will be short to medium term in duration ranging from approximately one year to 18 months. Education forms a strong part of any placement with the home being purpose built with teaching facilities on site; tuition is provided via an outreach programme as part of an agreement with a local specialised school.

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Summary

This inspection was unannounced and assessed all key standards. The home provides a good overall standard of care to young people. Care provision is the subject of detailed preparation and seen as an opportunity to develop each young person's experiences and abilities. The staff commitment and attitude ensures that intensive programmes of care can be implemented and amended when required. The manager and staff team work well together and evaluate their practice to ensure that high standards are suitably maintained. Robust internal and external monitoring of the home underpins the good quality of service offered to young people. The culture and ethos of the setting is starting to become more defined as the first year of operation approaches. Two recommendations were made as a result of this 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

One action was made at the last inspection in regard ensuring fire evacuation drills are completed regularly and recorded. Since the last inspection a good number of fire drills have taken place involving the whole staff team and young people; records of these events were accurate and clear.

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Improvements since the last inspection

Three recommendations were made at the last inspection. The first considered the need for new staff to be given a fire safety induction and for this to be recorded as having been completed. Records showed that all new staff had received suitable fire safety inductions.

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Improvements since the last inspection

The second recommendation concerned the need to record the details of physical interventions more clearly. Improvements have been made to record keeping with all incidents, where young people have required staff to intervene physically, being found to be recorded in detail.

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Improvements since the last inspection

The final recommendation noted the need for the independent regulation 33 visitor to sign the record of physical interventions to evidence they had been monitored by them. Physical intervention records now include the signature of the independent regulation 33 visitor, indicating they have reviewed the records during their monthly inspections.

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Helping children to be healthy

The provision is good. Young people are provided with suitable meal provision which includes the promotion of healthy eating. Young people have their particular likes and dislikes incorporated into menus. Foods 4 of 9 Inspection Report: SC399222 which young people particularly enjoy or dislike are recorded and used to inform future dietary planning. Meal times are an important part of the routines of the home. Staff are very mindful of each young person's learning difficulty and provide assistance and support as necessary in line with their particular care plan. Young people are also offered the opportunity to prepare food commensurate with their abilities and are given encouragement and support from the staff in order to achieve this.

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Helping children to be healthy

The health care needs of young people are met well. Robust care planning procedures ensure the physical, medical and emotional needs of each young person are considered in full. All young people living at the setting have a learning difficulty, details of which are paramount within health care planning, notably how they express displeasure, discomfort or pain. Health care plans are comprehensive and highlight all relevant issues including immunisation records and past and current medical histories. All young people are registered with local GP's.

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Helping children to be healthy

The culture of the setting places the individual needs of young people first. The complex health needs of the young people are met to a very high standard by the use of multi-disciplinary input and advice for the staff team. The specialised nature of the setting means that joined up working protocols are in place in meeting the emotional well-being of young people. Access to specialist support and assessment including speech and language therapy and clinical child psychology, is regular and on going.

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Helping children to be healthy

A safe and robust process ensures the storage and administration of medicines is addressed suitably. Staff receive appropriate training with only trained staff dispensing medication. Records of medication kept at the home were accurate, with good stock control monitoring procedures in place.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people have their privacy respected wherever possible. Clear and detailed individual protocols are in place for the staff to follow with regards to the carrying out of personal support and intimate care. In general confidential information relating to young people is stored securely in the office. Some records were kept in a cupboard which could not be locked; these were subsequently moved to a more suitable lockable cupboard.

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Protecting children from harm or neglect and helping them stay safe

While the home has a complaints process in place for the benefit of the young people, the staff are aware that many of them do not have the cognitive ability to know what constitutes a formal complaint. Therefore, the staff display a sound knowledge of how each young person communicates and how they show displeasure. No complaints had been recorded since the last inspection. No complaints have been received by Ofsted regarding the setting since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

A robust approach toward child protection ensures that young people are as a safe as they can be. All staff receive appropriate induction and training in key safeguarding matters. Robust policies and procedures address all areas of child protection and take into account local children's safeguarding protocols.

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Protecting children from harm or neglect and helping them stay safe

The levels of intense support offered to the young people ensures that behaviours which can impinge on other young people can be addressed and resolved promptly. While some of the young people may not understand the concept of bullying, the staff make it clear to them via 5 of 9 Inspection Report: SC399222 whatever means that they communicate, that behaviour which can cause distress to another is not condoned.

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Protecting children from harm or neglect and helping them stay safe

The staff are very aware of the high levels of vulnerability which the young people have due to their learning difficulties and lack of understanding of risk. High levels of support, both in the community and in the home ensure that no young people have gone missing. There are clear procedures in place should this occur.

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Protecting children from harm or neglect and helping them stay safe

Young people have their concerning and risky behaviours assessed, planned for and reviewed. Each young person has their particular issues identified during the admission process with expert advice incorporated into intervention programmes. As an intensive assessment service young people have their behaviours considered in depth with input from staff, teachers and psychologists. Staff are clearly committed to persevering with strategies often in the face of very difficult situations which can include violence toward themselves. Such a focus allows for behaviour management programmes to be amended to meet the specific needs of each young person. Very clear risk assessments provide staff with all necessary information relating to the young person in question including their vulnerability and risks.

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Protecting children from harm or neglect and helping them stay safe

All staff are trained in the model of physical intervention adopted by the setting. The levels of restraint reflect the behaviours exhibited by young people with their comprehension problems often making it more difficult for staff to de-escalate situations easily. Records of restraint are clear and accurate with all relevant incidents being noted including those where staff were forced to restrict the movement of young people for their own safety. All matters which involve the use of physical intervention are closely monitored and reviewed.

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Protecting children from harm or neglect and helping them stay safe

The health and safety of young people and staff alike is taken seriously. All electrical, gas and fire fighting equipment is routinely serviced and tested. The regular testing of emergency lighting and fire alarms occurs along with fire drills. The organisation have a comprehensive recruitment process with no members of staff working with young people until all the necessary checks and references have been confirmed.

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Helping children achieve well and enjoy what they do

The provision is good. Young people have their particular needs met extremely well with consistently high levels of individual support being provided. In keeping with the intensive nature of the setting the manner that young people have their specific and complex needs met is vitally important. Families are encouraged to have an input into developing the support plans, as are relevant professionals such as teachers, social workers and occupational therapists. The holistic approach ensures that all needs, whether physical or emotional, can be met to a very high standard.

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Helping children achieve well and enjoy what they do

Staff display considerable understanding of each young person's physical, medical and social care needs with a notable focus on their emotional well being. Routine child focus meetings review the individual progress of each young person with comprehensive care planning responding to changing needs and circumstance.

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Helping children achieve well and enjoy what they do

Young people are clearly encouraged and assisted to engage in their education. Education is provided on site as part of the key functions of the service. Each young person has a personal education plan. Care staff support education staff during school hours with the small size of the home aiding communication. The specific learning needs of each young person results in 6 of 9 Inspection Report: SC399222 focused and intensive educational plans needing to be implemented. Young people who have not experienced schooling for some time have programmes developed which allow them to re-engage with education at their own pace.

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Helping children achieve well and enjoy what they do

Activities in and outside of the setting are an important part of daily routines. Young people are encouraged to participate in a range of pursuits and to experience their local surroundings and community. Staff work very hard to support young people to broaden their interests away from the setting. Recent trips have seen young people visiting local swimming pools, parks and shops. Young people also participate in art and play within the home on a regular basis.

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Helping children make a positive contribution

The provision is good. Comprehensive admission and care planning procedures ensure no young person is admitted to the home without first being assessed as suitable for the setting. Young people admitted to the home will only have been referred there following panel agreement. All young people have their physical, social and emotional needs assessed and planned for with the complexity of needs relating to their learning disability of paramount concern.

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Helping children make a positive contribution

The individual needs of young people are assessed in detail being incorporated into robust care plans. Care plans provide staff with a clear guide of how to meet the particular needs of each young person. Care plans are completed in line with the overall looked after children placement plan with parents being encouraged to participate in the process.

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Helping children make a positive contribution

As an intensive short to medium term assessment setting a large part of the work is to ascertain what needs each young person may require longer term. On occasion this may mean certain young people are assessed as requiring a different type of provision and will therefore not stay at the home as they long as would have been initially envisaged.

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Helping children make a positive contribution

Regular reviews ensure care plans match the current needs of each young person in an individualised fashion. The whole staff team contribute to routine child focus meetings with specialist input readily available. Reviews focus on the progress of each young person against their care plan with expert guidance contributing to a holistic care approach.

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Helping children make a positive contribution

The particulars of any agreed contact arrangements are recorded in detail and are clearly known by staff. Where relevant staff facilitate contact arrangements. Risk assessments are completed for such visits and updated when and if necessary.

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Helping children make a positive contribution

Staff interaction with the young people is sensitive and supportive, allowing them to make choices whilst ensuring that their safety and wellbeing is protected and promoted. The young people are seen to be relaxed in the company of the staff who care for them.

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Helping children make a positive contribution

Each young person's method of communication is known by staff. The different forms of communication used by young people include sign language, vocalisation and augmented communication systems using pictures, symbols and objects of reference. The staff knowledge of each young person's communication and behaviour, together with information from parents and professionals ensures that each young person's preferences are known about how they wish to be cared for in the home. 7 of 9 Inspection Report: SC399222

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Achieving economic wellbeing

The provision is good. The upper age limit of young people moving on from the home is 12, therefore it is not expected for young people in this setting to be requiring support and guidance which would prepare them for adulthood. The changing and developing needs of young people as they grow older are considered appropriately and in keeping with their comprehension and abilities. Young people are supported to engage in some life skills work including cooking.

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Achieving economic wellbeing

The home provides young people with a reasonably comfortable place to live. All areas of the home were found to be very clean and hygienic with staff working extremely hard to maintain this level of cleanliness. Young people are able to personalise their own bedrooms with pictures, posters and photographs of their choosing. Communal areas offer young people adequate space and comfort with all modern entertainment items such as DVD and interactive games. A small courtyard is available for outdoor space and exercise although this appears somewhat bare in decor. The inside of the setting is furnished and decorated with the specific needs of young people in mind, notably those with severe autism. Although it is clear some young people would find bright or too many colours unsettling the predominantly white walls lack a homely feel. Some areas on the other hand display posters incorporating young people engaged in a

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Achieving economic wellbeing

variety of activities and pursuits which provides a nice touch.

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Organisation

The organisation is good. A sufficient amount of information is made available which outlines the aims and objectives of the setting and the services it offers.

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Organisation

The promotion of equality and diversity is good. In particular young people are assisted to lead and enjoy as inclusive and productive lifestyle irrespective of their particular learning disability. The complex needs of young people ensures staff plan to care for them in a detailed and individualised manner. Diversity and difference continues to be seen as an opportunity to learn from each young person and their specific wishes and needs. The management approach of the home clearly places the individual needs of young people in high regard with regular team meetings focusing on each young person to assess whether their particular needs and wishes are being met.

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Organisation

An appropriate number of staff are deployed during the day and night to care for the young people currently living at the home. The setting are not carrying many vacancies with any shortfalls being addressed by the use of a small number of regular agency staff. The staff team provides a good mix of experience, skills and enthusiasm.

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Organisation

Staff receive regular supervision and generally commented positively on the manner that they are supported and guided. Staff morale appears to be good with staff exhibiting energy and enthusiasm to carry out their tasks and develop their practice. Good training opportunities are offered which includes completing the required National Vocational Qualifications and scope to advance in further professional development. Relevant training is provided with recent courses undertaken including attachment theory and sensory interventions.

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Organisation

The registered manager and assistant manager work closely together to provide clear leadership and guidance. All aspects of care provision are closely monitored with a culture developing 8 of 9 Inspection Report: SC399222 which places the needs of young people as it's guiding principle. The organisation ensure the monthly Regulation 33 inspections are completed with these providing an objective review of the standard of care. The organisation also commissioned an independent review of the service assessing responses from staff, parents and other care professionals. The results were very positive and highlighted a young person centred environment, where care, education and specialist intervention strategies focus on individual needs.

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Organisation

Records seen during the inspection clearly evidence the progress and development of each young person placed at the setting.

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Organisation

It is fair to note that the first nine months of operation have been taxing for all staff with some young people exhibiting extremely challenging and difficult behaviours. It is testament to the dedication and commitment of the whole staff team that despite such pressures they continued to provide consistent care which is an essential element in caring for young people with such complex needs.

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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 all confidential records are stored securely (NMS 9.2) • consider improving the environment to enable the setting to feel more homely (NMS 24.1) 9 of 9 Inspection Report: SC399222

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