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

SC032600 Unique reference number 20 July 2010 Inspection date Paula Eaton Inspector Key Type of Inspection

p.1

16 February 2010 Date of last inspection .

p.1

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.

p.2

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

p.2

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.

p.3

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: SC032600

p.3

Brief description of the service

This short-breaks service provides care for up to five young people who have either physical and/or learning disabilities and also may have a sensory impairment, who are aged between 10 and 19 years of age. The home is owned and operated by a local authority. The home is located in a residential area close to local shops, a library and local swimming pool. The home also has good transport links into the town centre.

p.4

Brief description of the service

The ground floor of the home has a communal area that has a comfortable seating area, dining area, pool table and football table. There is also a sensory room and soft play area on the ground floor, as well as the shift office, kitchen, laundry room, bathroom and activity room with computer equipment for young people to use. All of the bedrooms are situated on the first floor along with further bathroom facilities and offices. There is a rear garden with play equipment for young people to use and a sensory garden. The home has appropriate adaptations to meet the needs of young people with physical disabilities that use the service.

p.4

Summary

This was an unannounced inspection that covered all of the key national minimum standards for children's homes.

p.4

Summary

This short breaks unit provides an excellent standard of care for the young people who use the service. Staff are highly motivated and committed to providing the best possible care for young people whilst ensuring that they enjoy a safe, fun and educational environment.

p.4

Summary

A holistic approach is taken to the care of each individual young person and any changing needs are observed and promptly addressed. Although young people only reside at the home for short periods of time, staff take an active interest in their overall well-being and development and strive to support them to reach their potential.

p.4

Summary

Management and monitoring systems within the service are also of an excellent standard and detailed records are maintained and kept up to date. The service has a consistent record of improvement and development and continues to seek ways to improve the service for young people. The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection.

p.4

Improvements since the last inspection

There were no actions or recommendations made at the last inspection.

p.4

Helping children to be healthy

The provision is outstanding. Yung people benefit from nutritious and varied meals that meet their individual dietary preferences and needs. Great care is taken to ensure that all staff are knowledgeable about any special diets that young people have and guidance is also sought from healthcare professionals where this is thought appropriate. For example, for one young person on a very specific diet the unit has contact with a dietician at Great Ormond Street children's hospital. 4 of 9 Inspection Report: SC032600 Care plans contain very detailed information about dietary needs and this is also contained in the menu file in the kitchen to ensure that all staff preparing food know young people's needs. Their food intake is closely monitored especially where there are health concerns and staff encourage young people to eat well and try new foods. Careful consideration is also given to the support young peopel require with eating and drinking to ensure that they enjoy mealtimes

p.4

Helping children to be healthy

As the unit is a short breaks provision parents and carers generally remain responsible for meeting the healthcare needs of their children. However, care plans contain very comprehensive details of each individual healthcare needs and any action staff should take to meet these. The unit often supports young people with very complex medical conditions and care is taken to develop clear guidelines to ensure that staff are consistent in their practice. This contributes to enhancing the well-being of young people who use the service. Staff work very closely with young people and their families and, as a result, are prompt to identify and address any changes in the well-being of a young person. Staff support families to seek professional healthcare services when required and maintain good links with all those involved in the care of individual young people to ensure a consistent approach to their care.

p.5

Helping children to be healthy

Staff also receive regular training to ensure they are appropriately skilled to meet specific health needs. For example, staff receive training on the use of Gastronomy devices and epilepsy; at the time of the inspection Cardiac Pulmonary Resuscitation (CPR) training had been arranged as a safeguard for one young person who uses the service. Healthcare professionals are also invited to team meetings to provide advice and guidance on specific issues. The majority of staff hold a paediatric first aid qualification and all staff receive training on food hygiene.

p.5

Helping children to be healthy

Robust systems are in place for the safe storage, administration and disposal of medication. Staff receive medication awareness training and new staff are fully supported in the administration of medication until they have the confidence, skills and experience to safely carry out these duties. Staff also monitor the affect of medication and pass relevant information on to parents and healthcare professionals where relevant. Guidance is developed for the management of medication for individual young people where this is appropriate to meet their needs especially with regard to the management of epilepsy.

p.5

Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. The privacy and dignity of young people is prioritised within the unit taking into consideration the individual needs and preferences of young people with regard to their personal space and support needs. Staff support them to be as independent as possible to avoid any unnecessary intrusion of their privacy. All staff receive moving and handling training to enable them to safely assist young people whilst maintaining their privacy and dignity. Appropriate policies and procedures are in place with regard to confidentiality and these include clear guidance for staff about their responsibilities in relation to dealing with sensitive information.

p.5

Protecting children from harm or neglect and helping them stay safe

Sound systems are in place for responding to complaints about the service. Information is accessible to parents, carers and young people so that they are aware of the process should they wish to raise any concerns. There are very low levels of complaints made about the service. Robust child protection policies and procedures are in place. Staff receive safeguarding training and are clear about their responsibilities with regarding to protecting children and young people from harm. Bullying in the unit is rare, however, relationships between young people are 5 of 9 Inspection Report: SC032600 monitored closely and any issues addressed promptly. Absconding within the unit is almost non-existent as staff ratios are high and the building secure to keep young people safe as a result of their complex needs and vulnerabilities. However, risk assessments are completed for any young person where there is an identified risk of them absconding and action is taken to

p.5

Protecting children from harm or neglect and helping them stay safe

A positive approach is taken to managing difficult behaviour. Very detailed behaviour management support plans are developed for young people as part of their care plan that include details of what circumstances may trigger certain behaviour and how staff should respond to minimise the impact of this behaviour on the young person and others. Staff liaise with other professionals to develop and implement creative strategies to support young people and reduce incidents of challenging behaviour. Staff receive training relating to behaviour management and physical intervention; however restraint techniques are rarely used in the unit. Sanctions are only imposed if they are meaningful to the individual young person involved and are dependent on the level of understanding of that young person. The manager and Regulation 33 visitor also monitor all records relating to behaviour management and take action

p.6

Protecting children from harm or neglect and helping them stay safe

to address any noted issues or questions raised.

p.6

Protecting children from harm or neglect and helping them stay safe

Comprehensive health and safety policies and procedures are in place and are adhered to by staff. Detailed records are maintained for all health and safety checks that take place and these are carried out at the required regular intervals. The service also carries out very thorough risk assessments of any possible or identified risks to young people, and reviews and updates these regularly to ensure that the welfare and safety of young people is maintained at all times. All fire safety equipment is checked at regular intervals and frequent fire drills take place. There is a system in place that monitors what young people are present at the time of fire drills so that staff can ensure that all young people experience the evacuation procedure. Individual emergency evacuation plans are in place for each young person.

p.6

Protecting children from harm or neglect and helping them stay safe

Robust recruitment policies and procedures are in place and all required checks are completed prior to individuals commencing work to ensure that young people are appropriately safeguarded. All recruitment is carried out by the local authority human resources department.

p.6

Helping children achieve well and enjoy what they do

The provision is outstanding. Young people are treated as individuals and staff are constructive and creative in finding ways to meet their needs whilst still making their stay at the unit fun and educational. Cultural and religious needs are observed and celebrated within the unit. Each young person has an allocated key worker who supports them ensuring that their care plan is up to date and individual needs met. Risk assessments are completed in relation to risks identified for individuals and careful consideration is given to providing stimulating, challenging and enjoyable activities that take into consideration individual strengths and preferences. Young people are encouraged to take controlled risks which support them in reaching their potential and achieving as much independence as possible. Comprehensive, informative daily records are maintained that provide a clear record of each young person's experiences whilst staying at the unit.

p.6

Helping children achieve well and enjoy what they do

As a short-breaks service parents and carers retain responsibility for the education of the young people who use the service. However, staff liaise with educational placements regarding the care of young people and strive to support them with their education and developing new skills. Each young person has an individual education plan in their case file so that staff are aware of 6 of 9 Inspection Report: SC032600 the educational goals and progress of each young person. Staff also support them with their homework where appropriate and maintain a copy of school reports.

p.6

Helping children achieve well and enjoy what they do

Young people benefit from a wide range of well organised and stimulating activities that are available to them. The rear garden contains outdoor play equipment that is accessible to children and young people with disabilities including a sunken trampoline, a wheelchair swing and a roundabout. There are also two tricycles that young people enjoy using and a sandpit and sensory garden where they have been involved in planting various plants. Indoors there is a football table, pool table and games console available as well as ample games, books, toys and computers. Staff also support young people to access leisure activities in the community that they would otherwise not be able to use for a variety of reasons. The needs and preferences of the individual young person are always considered when planning activities and any identified risks carefully assessed to ensure their safety.

p.7

Helping children make a positive contribution

The provision is outstanding. Careful assessment of each young person's needs takes place prior to them using the service to ensure that staff are equipped to care for them. Detailed care plans are then developed from the completed assessment which are revised and updated as staff get to know the young person and their needs change. Each young person is allocated a key worker who is responsible for maintaining their care plan. The care plans are very detailed giving a clear picture of the young person, their personality, preferences and influences as well as comprehensive information about their basic care needs. The care plans promote and protect the welfare of the young person and encourage individuality. Clear objectives are in place as well as clear guidance for staff regarding how they should meet the needs of the young people.

p.7

Helping children make a positive contribution

Staff take an active role in statutory reviews for the young people and the management team also contribute to these. Young people are encouraged to contribute where possible and staff routinely advocate on behalf of young people in this forum. Detailed review reports are completed for review meetings and actions agreed during the meeting are promptly followed up by staff and monitored by the management team.

p.7

Helping children make a positive contribution

Young people only visit the unit for short breaks and generally live with their families so therefore it is not necessary for the unit to arrange contact. However, staff maintain contact with families to keep them updated about any concerns or developments and parents are able to maintain contact with the young person during their stay if they wish to do so. Clear information about any restrictions on contact are clearly recorded and there are also clear arrangements in place for who can collect a young person from the unit depending on the wishes of parents.

p.7

Helping children make a positive contribution

Very clear protocols are in place for introducing young people to the unit. Visits to the unit take place, such as tea visits so that they can familiarise themselves with staff and their peers; the young person is able to meet with their proposed key worker during this time. Staff also ensure that young people are fully supported when they move on from the unit into adult services. For example, a slow induction takes place where the young person will visit for short periods of time and the manager liaises closely with the new service to ensure that they are aware of the young person's support needs. 7 of 9 Inspection Report: SC032600 The individual communication needs of young people are clearly recorded to ensure that they can be actively involved in decision making wherever possible. Questionnaires are adapted taking into consideration the most effective means of communication for individual young

p.7

Helping children make a positive contribution

people so that they are able to contribute their views regarding the service provided at the unit. Parents and carers and other stakeholders are also encouraged to express their opinions about the service and an open and transparent system of working is adopted by the unit. The unit arranges an annual communication day that involves seeking the views of parents, carers and young people in a creative and fun way whilst still enabling them to do this confidentially if they wish. A suggestion box is provided for views to be shared during the day and alternative arrangements are made to seek the views of those young people and parents unable to attend the event.

p.8

Achieving economic wellbeing

The provision is good. The unit has introduced a new regular semi-independence night for older young people. This involves developing semi-independence training programmes for young people based on their individual needs and level of ability. For some this has included an independent travel programme that supports them to learn to use public transport safely. All young people are encouraged and supported to develop skills that enable them to be as independent as possible in preparation for moving on to adult services.

p.8

Achieving economic wellbeing

The unit is located in a residential area close to local community resources. There is a local swimming pool nearby as well as local shops and the unit is a short distance from the local town centre. There are also social work teams located close to the unit which supports multi-agency working. The house is appropriately adapted to meet the needs of the young people who use the service and all equipment is maintained to a good standard.

p.8

Achieving economic wellbeing

The furniture and décor within the unit is of a good standard. Any maintenance issues are promptly reported and addressed. Each bedroom has a colour theme and young people, where possible, are given a choice of what room they will stay in. They are encouraged to bring personal belongings with them for their stay at the unit and there is ample communal space and rooms available for visitors to meet in private.

p.8

Organisation

The organisation is outstanding. The Statement of Purpose for the unit is kept up to date and contains all of the required information. There is a children's welcome guide that is produced in the form of a DVD that provides a more appropriate visual and auditory guide to the unit for the young people who use the service.

p.8

Organisation

The promotion of equality and diversity is outstanding. The service strives to provide a service tailored to meet the specific individual needs of young people and promotes a holistic approach to working with them that considers all aspects of diversity. Staff are knowledgeable about the needs of young people and are consistent in their proactive approach to meeting these for individuals, seeking professional support and guidance where required.

p.8

Organisation

All but recently recruited staff members have completed their National Vocational Qualification at Level 3. There is a formal handover period between shifts that ensures that all relevant 8 of 9 Inspection Report: SC032600 information is passed on to inform planning for the shift ahead. Appropriate risk assessments are in place for lone working, although this is a rare occurrence and there are senior staff available at all times. The service has a good line management structure and clear lines of accountability ensure that staff are effectively managed which contributes to the excellent service provided for young people.

p.8

Organisation

Clear training records are in place for staff. Core, mandatory training is provided as well as training that meets the specific needs of young people who use the service. For example, CPR training had been arranged as an additional safeguard to meet the health needs of one particular young person who uses the service. Training is delivered in a variety of ways and from a variety of sources with external training and advice and guidance being sought from other professionals to equip staff with the knowledge and skills to meet the needs of individuals. Recent training has included person-centred thinking, food hygiene and behaviour management training. There is a comprehensive induction programme in place for any new member of staff that involves experienced senior staff working with new staff to ensure their understanding of the systems and procedures within the unit.

p.9

Organisation

Excellent monitoring systems are in place that cover all aspects of the day-to-day running of the unit. The manager regularly monitors and comments on all records and takes steps to address any inconsistencies or shortfalls. Regulation 33 visits are also carried out on a monthly basis and detailed reports prepared and prompt action taken to address any issues identified.

p.9

Organisation

Secure records are maintained for young people and these contain all of the required information.

p.9

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.

p.9

Recommendations

There are no recommendations. 9 of 9 Inspection Report: SC032600

p.9