Children's Home run by Isle of Wight Council in Isle of Wight

SC395944 Unique reference number 17 August 2010 Inspection date David Coulter Inspector Key Type of Inspection

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15 December 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: SC395944

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Brief description of the service

This children's home is a purpose built respite facility located in a semi-rural area close to a town. It is owned and operated by the local council. It is accessible to many of the town's facilities and major transport links.

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Brief description of the service

The accommodation is specifically designed to meet the needs of young people with multiple disabilities; it is equipped with appropriate lifting equipment including overhead hoists. All young people are provided with their own rooms. The home is on one level and has a safe enclosed garden accessible to the young people.

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Brief description of the service

It is registered to take up to six young people with learning difficulties and/or physical disabilities between the ages of five and 17 years.

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Summary

This unannounced full inspection assessed the key national minimum standards for children's homes. Particular attention was paid to the outcomes for young people in key areas such as being healthy and staying safe. Evidence was obtained via parental and young people’s questionnaires and an examination of a wide range of records and documents. Discussions with staff and observations of the interaction between young people and staff were also undertaken. The inspection also included a full tour of the home and its facilities. The home provides respite care for up to forty young people with complex care needs.

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Summary

Evidence indicates the home provides outstanding respite care to a group of extremely vulnerable young people with complex needs. Care is provided by a group of experienced and committed staff team who are conversant with needs of each young person. They have established effective communication systems and regularly ascertain the views of young people about all aspects of their care during their stays. Staff are pro-active in advocating on each young person's behalf in an effort to ensure they can access appropriate resources and services.

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Summary

The care needs of each young person are clearly identified prior to admission and detailed strategies developed to ensure they are effectively met. The homes nursing staff provide guidance on all health related issues. Staff have established good lines of communication with parents and teaching staff and this has led to much greater consistency in the delivery of care in different settings. Parents are extremely appreciative of the staff support provided to both them and their children. Young people observed during their visits appeared to be thoroughly enjoying themselves and it was apparent that they had established extremely good relationships with the staff.

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Summary

Evidence collected during the inspection indicates that the home operates within a well established risk management framework that keeps young people and staff safe. An effective monitoring system ensures that all policies, procedures and working practices are subject to regular review and are updated in response to changing circumstances. The home provides care that was described by parents as 'fantastic' and 'excellent'. The home’s dedicated staff team, that is led by an extremely able manager, display a real commitment to meeting the needs of the young people with whom they are working. Staff not only strive to improve the service they offer, but wish to extend it for the benefit of more young people. There are no 4 of 9 Inspection Report: SC395944 recommendations or actions arising from this inspection and the quality of the provision is judged to be outstanding. The overall quality rating is outstanding.

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Summary

This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The one action from the last inspection, relating to the establishment of a young person's register, has been appropriately addressed.

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Helping children to be healthy

The provision is outstanding. Although young people undertake short stays at the home, staff take the opportunity to promote the concept of 'healthy living' by encouraging them to eat healthily and by engaging in physical activities. Fresh food is prepared on the premises by a dedicated cook and experienced staff. Individual's preferences and special dietary needs are incorporated into menu plans. Staff have undertaken specific training to assist young people who require assistance eating. Evening meals are often used to introduce young people to food from different cultures. Fruit and healthy snacks are available in between meals. Meals are social occasions and young people and staff eat together in a dedicated dining room. Comments from young people and their parents indicate that the food on offer is of good quality and sufficient quantity.

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Helping children to be healthy

The specific health needs of each young person are clearly identified as part of a core assessment. Prior to any respite stay, the homes experienced nursing staff liaise with parents and other health professionals to ensure that appropriate guidance is produced for staff on how the often complex care needs of each individual can be appropriately met during their visits. Nursing staff also provide information on specific medical conditions and syndromes associated with this client group. Staff have completed training on first aid and a number of delegated health tasks to ensure appropriate support is always available. There are excellent systems in place to ensure that the well-being of each young person is monitored on an on-going basis. Any worries or concerns relating to a young persons health are immediately relayed to parents, social workers and allied health professionals.

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Helping children to be healthy

Arrangements for the storage and administration of medication are extremely good. Medication is stored in a designated locked facility and dispensed by staff who have completed specific training. Staff are made aware of the possible side effects of the medications prescribed to young people. Nursing staff undertake regular audits of medication. Due to the nature of their disabilities, all the young people require staff assistance to undertake personal care tasks. Staff carry out such tasks sensitively. The home has a range of equipment, including overhead hoists, to assist the personal care of young people with mobility difficulties.

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. Staff operate a 'child centred approach' to care in which each young person is treated as an individual. One-to-one working provides staff with the flexibility to respond effectively to the changing needs of each individual. The privacy of each young person is given a high priority and each individual is assigned their own room for the duration of their stay. Each young person's room is prepared for them prior to their visit with familiar objects such as posters. Due 5 of 9 Inspection Report: SC395944 to their health needs, many of the young people require visual checking at regular intervals throughout the night. Non-intrusive systems ensure that young people's sleep will not be disturbed. Shutters on external windows are used for those young people who are sensitive to light. Staff treat young people with dignity and respect and issues, such as personal care, are dealt with sensitively. Confidential information relating to each young person is kept in an

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Protecting children from harm or neglect and helping them stay safe

Staff have established a comprehensive range of policies, procedures and working practices to keep young people safe in both the home and local community. The home operates within a risk management framework and is subject to regular health and safety checks. Access to the building is limited and all visitors have to report to staff on admission, produce identification and sign in. Risk assessments are developed in respect of each young person and updated in response to changing circumstances. Due to their vulnerability, none of the current residents are safe to leave the home unaccompanied. Staff carry 'key information folders' on each young person that can be relayed to police in the unlikely event of them going missing.

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Protecting children from harm or neglect and helping them stay safe

The home has a child protection policy and there are clear guidelines for staff on the reporting of any concerns to the area safeguarding team. All staff receive training on child protection. Staff utilise body maps to record any bruise or mark observed on a young person's body. Staff spoken with were clearly aware of their personal responsibilities in regard to reporting any worries or concerns.

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Protecting children from harm or neglect and helping them stay safe

Behaviour management guidance is developed in respect of each young person and is regularly updated. Staff liaise with parents and teaching staff to achieve a consistent approach. Staff reinforce positive behaviour and young people are helped to make the link between actions and consequences. It is evident that staff are conversant with the specific behaviours of each individual. Although staff do not currently consider bullying to be a problem, their are a number of young people who may strike out when frustrated. By the use of appropriate staffing levels, careful planning and monitoring, staff minimise the risk of such incidents occurring. While staff have undertaken training in the use of physical interventions, they are only ever used if it is felt a young person is putting themselves or others at risk. Challenging behaviours are normally managed by the deployment of diversionary strategies. There is a good system for recording

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Protecting children from harm or neglect and helping them stay safe

physical interventions and other significant incidents. Each incident and its antecedence are examined in an effort to prevent a reoccurrence.

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Protecting children from harm or neglect and helping them stay safe

As the majority of young people using the service experience communication difficulties, staff deploy a range of techniques, including sign language and pictorial cards, to seek out their views. Staff are pro-active in addressing any worries before they develop into major concerns. The home has a written complaints policy and all young people, their parents and placing social workers are made aware of it on admission. No complaints have been made since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

The local authority has a comprehensive recruitment procedure that requires applicants to complete a detailed application, submit to a Criminal Record Bureau check and provide two written references. All new staff have to complete a detailed induction programme and successfully complete a six monthly probationary period before becoming permanent staff. All new staff work alongside experienced staff until they are deemed competent. 6 of 9 Inspection Report: SC395944

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Helping children achieve well and enjoy what they do

The provision is outstanding. The home currently offers placements to over thirty young people. While most visits consist of an overnight stay there has, in recent times, been an increase in the provision of after school visits. A well-established link-worker system ensures that the progress of each young person is regularly monitored and provides parents and social workers with a consistent point of contact. Link-workers contribute to reviews by preparing written reports. Parents reported that the homes staff are excellent at keeping them informed and always make themselves available to discuss any worries or concerns. It is evident that the home's staff provide invaluable support to families who are often under great pressure. Each morning staff discuss the specific physical, social and emotional needs of the young people being accommodated and make plans for their arrival. Any significant issue arising during a young persons visit is recorded and incorporated

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Helping children achieve well and enjoy what they do

into the planning process for their next stay.

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Helping children achieve well and enjoy what they do

All the young people attending the unit have special educational needs and are in full time educational placements. Staff have established good links with teaching staff and attend educational reviews. Regular and effective liaison with parents and teachers has led to a greater consistency in approach in areas such as behaviour management. During school term staff will provide transport to and from educational placements.

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Helping children achieve well and enjoy what they do

Staff aim to ensure that each young people enjoy their respite visit and that they are not only well cared for but have lots of fun. Young people are provided with access to a range of social and recreational activities within the home and local community. Although young people can exercise choice over their social and recreational activities, staff encourage them to experience new activities. For example, the home has a trampoline and bicycles that provide opportunities for young people to develop their independence. Young people in the older age group are provided with opportunities to develop independent living skills such as shopping and cooking. The achievements of all young people are both acknowledged and celebrated and the walls of the home are covered in photographs and certificates of their many achievements.

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Helping children make a positive contribution

The provision is outstanding. Referrals to the home are made via an interagency group of professionals. The specific care needs of each young person are identified via a comprehensive assessment. There is clearly great demand for the respite service and the home has a waiting list. The manager and staff are clearly aware of the demand and aim to ensure that that those accessing the service will benefit and fall appropriately within registration categories.

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Helping children make a positive contribution

Staff are extremely successful in implementing transition plans that enable young people to enter the home gradually and with minimum stress. There is provision for parents to stay and support staff during the transition process. Prior to admission young people and their parents are provided with information that details life within the home. A young person’s guide has been produced in a number of different formats. Staff work closely with aftercare teams to ensure that young people make successful transitions to adult service provision.

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Helping children make a positive contribution

Staff have developed a comprehensive planning process that has proved to be an effective mechanism for ensuring that the identified care needs of each individual are being met appropriately and adjusted in the light of any changing circumstances. Placement plans are 7 of 9 Inspection Report: SC395944 developed in conjunction with the young person, their parents, teachers, medical staff and placing social workers. All placement plans are subject to regular review. Placement plans examined were found to be thorough, accessible and written in clear unambiguous language.

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Helping children make a positive contribution

During the course of the inspection it was possible to observe the interaction between a number of staff and young people. It was evident that staff were fully conversant with the specific care needs of the young people with whom they were working. In all instances young people were being treated with respect. Staff had established effective means of communication with the young people with whom they were working and were able to engage in playful banter. The views of young people were being sought about all aspects of their care and a number of young people were observed exercising choice over the activities they wished to undertake. All the young people observed appeared to be at ease in both their surroundings and the company of staff with whom they were with.

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Achieving economic wellbeing

The provision is outstanding. During their visits young people are provided with opportunities to experience new activities and by so doing increase their self-confidence. However, staff are clearly aware that, due to their disabilities they require a high level of support. Young people make considerable progress in areas such as personal care, communication and social interaction. All training is tailored to the needs and capabilities of each individual. Staff are extremely patient and work at a pace appropriate to each individual. Staff are clearly aware of the vulnerabilities of each individual and risk assess all activities.

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Achieving economic wellbeing

The home, a purpose built facility, is well designed and provides flexible and spacious accommodation with an appropriate number of communal areas. Being on one level means it is accessible to young people with mobility difficulties. It is situated in a good location and is accessible to a range of facilities including shops and a park. The home is structurally sound and in generally good decorative order. Specialised facilities are good and include specially adapted bathrooms and overhead hoists. The home is subject to constant use and requires maintenance on an on-going basis. Records indicate that all requests relating to health or safety are dealt with promptly. However, routine maintenance including regular redecoration and refurbishment, can take some time. The home has a development plan and facilities are being upgraded on a gradual basis. Since the last inspection new carpets have been introduced and

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Achieving economic wellbeing

a new monitoring system for young people’s bedrooms installed. Outdoor facilities include a trampoline and large enclosed play area with paths for cycling. Funding has been secured for a new play area and work is due to start in the autumn. One section of the premises remains unused and while this does not impact negatively on the running of the respite service, parents and staff expressed the view that it was a shame that it could not be utilised to provide respite placements for those on the waiting list.

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Organisation

The organisation is outstanding. The home has a comprehensive Statement of Purpose that clearly reflects the nature of the respite service. The Statement of Purpose is subject to annual review and copies are made available to parents and placing social workers as part of the admission process. A young person's guide has also been produced in a pictorial format for young people with communication difficulties. 8 of 9 Inspection Report: SC395944 The home operates with a stable team of experienced permanent staff. The staff team includes both nursing and care staff. The knowledge and skills of all staff are utilised to ensure that the complex care needs of individual's are effectively met. Parent's commented positively on the professionalism of staff and there was universal appreciation of their commitment to meeting the needs of young people. Special mention was made of the outstanding leadership provided

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Organisation

by the homes manager. Staffing levels are continually reviewed and increased in line with changing circumstances. All shifts are managed by experienced members of staff.

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Organisation

There is a well established culture of training and development within the staff team and expectation that each member of staff will assume personal responsibility for their professional development by accessing the many training opportunities on offer. A record of all training undertaken is kept on staff files. The manager closely monitors training records to ensure that staff meet mandatory training requirements. Over 80% of staff have gained the national vocational qualification at level 3 or higher. All staff, including the manager, receive regular supervision.

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Organisation

The home has a comprehensive range of policies and procedures that are accessible to all staff. Minutes of regular staff meetings indicate that staff engage in reflective practice and continually review their work to ensure they remain responsive to changing demands. Internal monitoring systems are effective and recommendations arising from monthly regulation visits are appropriately addressed. During the course of the inspection a range of records and documents were examined. All contained recent and relevant information and were written in clear accessible language.

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Organisation

The promotion of equality and diversity is outstanding. The religious and cultural needs of each young person are identified on admission and plans developed to ensure they can be met during their stays. All staff receive training in equality and diversity issues and are pro-active in promoting the rights of young people with disabilities. Each young person is treated as an individual with their own specific care needs and staff continually advocate on their behalf to ensure they can access appropriate resources and services. During their visits young people are provided access to a range of different cultural experiences. In recent times this has included visits to a music festival. The home benefits greatly from the support it receives from the 'Friends of Beaulieu', a charitable organisation that, amongst other things, raises funds to supply additional equipment. The organisation helps staff maintain strong links with the local

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Statutory requirements

This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, The Childrens Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales.

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Recommendations

There are no recommendations. 9 of 9 Inspection Report: SC395944

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