Children's Home run by Leicester City Council in Leicester

Unique reference number SC039056 Inspection date 27/08/2010 Inspector Warren Clarke Type of inspection Key

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Date of last inspection 01/02/2010 Website: www.ofsted.gov.uk

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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 Crispins, 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.

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About this inspection

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 outcomes for children set out in the Children Act 2004 and the relevant National Minimum Standards for the service.

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The inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough

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Brief description of the service

This children's home is operated by a local authority and is situated in a residential area in the north-east of the city. It is registered to provide short break or respite care for up to nine children and young people from the age of eight years to under 18 years. The children are mainly accommodated in one of two units. One unit accommodates children with learning difficulties who also have wide ranging physical disabilities and, in some cases, complex health needs. The other unit provides accommodation to children who often exhibit challenging behaviours allied to their learning difficulties. Each episode of respite care is generally planned in advance; however, the service also aims to respond to emergency family situations where this is in the child's best interests. Two young people, exceptionally, are currently being accommodated in the home on a continuous basis.

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Brief description of the service

The building is specially designed for its purpose and is mostly at ground level. It is divided into separate areas, one being exclusively for administrative use and accommodating facilities and services accessible to the children in residence, but not exclusively. Both of the residential units are self contained and offer single bedroom accommodation, dining, bathroom and toilet facilities. A two-storey section of the building has been equipped as a training flat to aid young people in preparation towards greater independence.

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Brief description of the service

Currently the home provides a service for a total of 34 children and young people. There were six children present during the inspection, four of whom were seen and contributed to the process.

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Summary

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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Summary

This announced key inspection assessed the home's performance against national minimum standards relevant to the Every Child Maters outcome areas: being healthy, staying safe, enjoying and achieving, positive contribution, economic wellbeing and organisation.

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Summary

The home is consistent in providing children and young people with an exceptionally high standard of care. It excels in ensuring that staff are trained to meet the needs of children with complex disabilities and related health problems so that they benefit from the social opportunities to promote development and well-being. Commitment to improving the lives of disabled children is evident in the flexibility of respite care and the wide range of associated services the registered provider makes available from the same site. Children are content in the home, they relate well to staff and enjoy the wide range of activities and leisure facilities. Compliments from parents suggest that some children look forward to staying at the home and thrive in its environment. Excellent work is also seen in the nurturing of children who are accommodated on a continuous basis. Where, for example, some of these children are admitted to the

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Summary

home in a crisis, within a short period they have made verifiable development gains such as in areas of mobility.

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Improvements since the last inspection

There were not requirements or recommendations at the last inspection.

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Helping children to be healthy

Particularly high standards of facilities and services continue to be provided and they respond precisely to the children's health needs. These include the catering arrangements that ensure mealtimes are carefully planned so that the children dine communally, in comfort and benefit from these enjoyable inclusive social events. Catering and care staff work together effectively. They ensure that where special diets, for medical, religious or preferential reasons are required, these are provided to the satisfaction of children and parents. All the children are provided regular, wholesome meals almost all of which are prepared on the premises using basic ingredients. The children are consulted and contribute to the menu planning by imaginative means where they have communication difficulties. It is observed that staff make particular efforts to ensure that children who are fed unconventionally, are also included in the social dining experience.

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Helping children to be healthy

Compliments from parents and social workers attest to the excellent standard of service, which endures in enabling children, some of whom have complex disabilities and health problems, to experience group living outside their families. These children are thereby benefiting from the associated social and personal development opportunities that this permits. Excellent health care arrangements such as providing appropriately trained and competent staff and a wide range of adaptations, aids and equipment ably facilitate these opportunities. For example, the hoists and other equipment enable staff to assist the young people with aspects of personal or intimate care safely and in ways that promote privacy, some independence and preserve dignity. Individual health plans for each child, which form a discrete aspect of the overall care or placement plan, are used effectively. Accordingly, there is clarity about each child's health needs and robust strategy links identified needs to

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Helping children to be healthy

day-to-day care inputs. This approach which fully involves children and their parents, demonstrates an efficient working partnership with health professionals and succeeds in ensuring each child gets the precise care he or she needs.

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Helping children to be healthy

Staff ensure that they have the necessary written consent to provide or arrange any treatment that a child might need. This includes administering both prescribed and non-prescribed medicines and first aid. All care staff have completed first aid, safe handling of medication and other relevant training that equips them to care for disabled children with the safety and competence that they consistently demonstrate. A sound medication policy and associated procedures in place, ensure that all medicines are safely stored, administered and documented. Combined with rigorous monitoring, efficient communication among staff, parents and schools, these measures avoid serious errors and safely accommodate the requirements of children who are on complex medication regimen.

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Protecting children from harm or neglect and helping them stay safe

Staff take full account of the children's disabilities and, in some instances, their high level of dependence. This is reflected in careful organisation of resources and shaping of care practices. For example, the home is highly equipped to promote each child's or young person's privacy and preserve their dignity. Each child is provided an exclusive bedroom, which is suitably fitted with aids and equipment appropriate to meet his or her needs. Any assistance with intimate care is given in private and children are supported to be as independent as possible in aspects of their own care such as dressing, bathing and toileting. These arrangements are complemented by excellent policies, procedures and practices which are strictly applied to ensure the children's personal details are handled confidentially.

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Protecting children from harm or neglect and helping them stay safe

A strong commitment to empowering children and others on their behalf to comment on the quality of the home's care and services is evident. It is expressed in the comments, compliments and complaints quality assurance system. This enables children, parents or others, to make comments or suggestions for improvements, compliment outstanding service and complain when the quality of service is unacceptable. The system includes a discrete complaints procedure, which is actively promoted to the children and young people in a format appropriate to their age and understanding. Communication difficulties experienced by some children are properly recognised and therefore manager, staff and official visitor act as effective advocates. For example, staff are alert to some children's particular means of making their wishes and feelings known and are committed to advocating on their behalf. Where complaints are made, there being none for some considerable time,

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Protecting children from harm or neglect and helping them stay safe

they are taken seriously, considered fairly and resolved satisfactorily.

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Protecting children from harm or neglect and helping them stay safe

Staff at all levels recognised the importance of acting to safeguard the children from abuse. This therefore features as a high priority. All staff are provided with relevant training and guidance that equips them well to understand the nature of abuse, act to prevent it and to respond to any allegations or suspicion of it appropriately. This includes acting to protect disabled children and those with additional communication needs who are particularly vulnerable. This is underpinned by an effective safeguarding policy and procedures consistent with those of the Local Safeguarding Children Board all combined in a successful safeguarding strategy. The manager and staff demonstrate that that they are effective in protecting children whose behaviour generally compounds their risk of abuse and employ stringent safe caring strategies in the home when necessary. The safe care of the children includes their protection

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Protecting children from harm or neglect and helping them stay safe

from bullying, which does not feature as a problem, and other behaviours which might threaten their comfort and well-being.

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Protecting children from harm or neglect and helping them stay safe

Appropriate procedures and an established local agencies protocol are in place to respond to any event of children being missing or absent from the home without permission. The procedures and protocol properly recognise the children's vulnerability and the urgency necessary to recover them should they be missing. Balanced against this are a range of excellent measures to ensure that staff are aware of the children's whereabouts at all times including when on outings from the home.

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Protecting children from harm or neglect and helping them stay safe

Staff are provided with clear guidance to assist the children to manage their behaviour and to enable reasonable control and discipline to be maintained. The success of this means that the children benefit from the home's rich and enjoyable care experience. Clear parameters are set out within which staff must operate, ensuring their disciplining is proportionate and takes account of the children's and young people's age and level of understanding. The principal approach of encouraging and reinforcing acceptable behaviour is most successful. Staff are observed to respond with reasonable firmness to poor potentially harmful conduct, but do so in ways that are helpful to the children's learning and without frequent use of sanctions. Physical intervention or restraint is used only where children or young people are causing harm to themselves or others. For instance, some children bang their heads or occasionally behave harmfully towards others. In these instances the

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Protecting children from harm or neglect and helping them stay safe

nature of the physical intervention is to stop a child from doing so by simply guiding them away. A particularly positive feature of the home is the good relationships between children and staff. Almost all the staff are long serving members and have shared in the care of most of the children over several years. This has caused them to become adept at anticipating and deflecting the children from behaving unacceptably.

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Protecting children from harm or neglect and helping them stay safe

The home is maintained as a safe environment for the children in which they are successfully protected from harm by a wide range of well-established health and safety measures. These include compliance with necessary assessments and risk management in all areas such as fire precaution, use of aids and equipment and other activities involved in the care of particularly vulnerable children. The range of security measures in place provides effective protection of the children from intruders. It is observed, however, that there are some lapses in testing of the fire alarm at the specified weekly frequency. Also some of the wooden outdoor play facilities are splintering, showing signs of rot which causes nails to become exposed and therefore presenting a potential hazard.

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Protecting children from harm or neglect and helping them stay safe

The well-established system remains in place, which ensures that staff selected to work in the home, or on the premises, are suitable to look after or have substantial contact with children. The registered person operates a rigorous staff selection and vetting process which includes assessment of competence and carrying out of checks such as criminal records disclosure of all those who are employed. This process is additionally scrutinised by one of the registered provider's senior managers to ensure it is as stringent as possible. Acceptable arrangements in place also ensure there is control and supervision of visitors.

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Helping children achieve well and enjoy what they do

Children and young people accommodated in the home are provided exemplary care that addresses needs arising from their disabilities and other personal characteristics such as their sex, race, culture and religion. The home specialising, most successfully, in the care of children with disabilities has coherent methods for promoting children's development. Children experience positive social and personal relationships and live fulfilled lives in its environment that promotes and reinforces their positive self-image. For example, staff skilfully manipulate the home's environment so group living and other social opportunities arising from this, such as communal dining and group leisure activities, ensure the inclusion of all the children. Staff are also adept in helping young people to understand physical changes, personal health matters and promote behavioural adjustments required to achieve greater independence and development towards adulthood. Apart from parents and

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Helping children achieve well and enjoy what they do

staff, the young people have access to a wide range of legitimate adults to whom to turn with any personal problems they may have.

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Helping children achieve well and enjoy what they do

Staff continue to work successfully within an accomplished policy that effectively supports the children's education. That is, the children benefit from a stimulating environment in which they blossom. The emphasis is on fun and enjoyment through play and a wide range of leisure pursuits some of which promote learning. All the children are in permanent and full-time education and achieve regular school or college attendance. Although parents retain overall responsibility for the education of children accommodated on a respite basis, staff are effective in ensuring there is no disruption to those children's existing education arrangements. Where occasionally children are accommodated on a more permanent basis a good track record of success is established in supporting them to capitalise on their talents.

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Helping children make a positive contribution

Children continue to be provided consistently high standards of care directed by an excellent assessment and care management system. This is reflected in each child's needs being clearly identified, clear outcomes established and an action plan of routine daily care inputs that meet his or her needs precisely. The success of this is evident in the care of the children's health, education and personal development with particular regard to communication and socialisation. Significantly, there is demonstrable commitment to include and empower children and parents so that the care provided and outcomes to be achieved are in accord with requirements and aspirations.

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Helping children make a positive contribution

A successfully proven management system is established for monitoring and review of the children's and young people's progress. Records are kept of daily care inputs and of the children's individual responses. Monitoring mechanisms such as progress discussions at staff meetings, end of stay reports and official review of placement plans, ensure that any difficulties or lack of progress are quickly identified and addressed. In each child's case, therefore, there is clarity about what is to be achieved, by what means and reasonable measure of impact and outcomes. In short, this is an establishment in which children enjoy a good quality of life and thrive relative to their personal circumstances.

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Helping children make a positive contribution

The home demonstrates that it works in effective partnership with parents and makes flexible arrangements for contact between children and their families. Such contact arrangements are firmly established in the care planning for children, particularly those who are permanently accommodated.

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Helping children make a positive contribution

A long established and accomplished process remains in place for introducing children to the home and for planning their leaving. Where a child is joining the home for the first time, this is handled with utmost care and sensitivity to overcome any anxiety this may evoke for them and their parents. There is an efficient system for receiving referrals, assessing whether the home can meet a child's needs and for introducing the child in a planned and gradual way. A similar process is employed to prepare children for leaving the home. This process takes full account of the firm attachments some children will have made. Accordingly, in some instances, a member of staff accompanies children on transfer to a new setting and works along side the staff until children are settled in the setting to which they have been transferred.

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Helping children make a positive contribution

Staff are provided clear guidance in building children's and young people's capacity, particularly those with communication difficulties, to participate and to be consulted about decisions about their future, their day-to-day care and how the home is run. The children present at the time of inspection were not able to give their views about this, but were observed to be completely at ease with staff. The staff knew how the children prefer to be assisted with certain aspects of care such as styling of their hair. They are approachable and alert to communication cues from children who are unable to make their feelings and needs known conventionally.

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Achieving economic wellbeing

The majority of children are accommodated in the home on a sessional basis and therefore their overall preparation for adulthood rests principally with their parents. Staff nevertheless make a significant contribution. They provide the children the opportunity to live away from home in a setting where they are successfully taught, and are able to rehearse, social skills. Development towards greater independence is also successfully promoted in activities in daily living such as washing, dressing. This is in line with the children's age and understanding and as their disabilities permit. In this connection, staff capitalise efficiently on the home's resources to provide the children added value to their respite care. This is all augmented by other services, such as a youth club with facilities for practising skills such as cooking, operated from the same site but independent of the home. Indeed, the home and the

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Achieving economic wellbeing

complementary services on the same premises represent a model of good service provision for disabled children, young people and their families.

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Achieving economic wellbeing

The home provides children a comfortable and safe living environment. The building is maintained in sound structural condition, appropriately furnished and has been refurbished and extended in some areas. This has enhanced its facilities and ensured that it is equipped to a very high standard to meet the needs of children with disabilities. The largely self-contained units in which the children are cared for present as homely. They are arranged and adorned to create a pleasing environment appropriate to the children's needs. However, carpets in some areas are stained and this detracts from the overall clean and orderly condition of the home.

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Organisation

The home continues to be managed competently, providing a flexible range of services to disabled children and their families. The quality of the short break care is exceptional and enables the children to thrive. This is founded on clear principles and practices matched by the necessary resources as set out in the current Statement of Purpose. This document complies with the relevant regulations and accurately reflects how the home is actually run. Information from the Statement of Purpose is helpfully summarised and presented in an appropriate format: a guide for the children and parents. The guide provides information about the standard of care and services children and young people can reasonably expect.

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Organisation

Staff are employed in sufficient numbers, efficiently deployed and respond effectively to the children's needs. There is clear accountability and management and leadership arrangements succeed in ensuring continuity and consistent care of the children. Children benefit from management's success in assembling, developing and retaining a high calibre of qualified and experienced staff. This impacts particularly upon children with complex health problems and a high level of dependency. They receive the skilled physical care required and therefore benefit from the enrichment that their full inclusion in the home's social life provides .

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Organisation

Staff consider that they are well supported and provided with the time and resources to perform their duties to a high standard. The staff team is highly trained and skilled in the care of children with learning and associated disabilities. This arises from the registered persons' firm commitment to staff training and development. There is an established induction and foundation programme for new staff together with comprehensive ongoing in-service training and development opportunities for experienced staff. This enables staff to continually update their knowledge and skills and contributes to the enduring competent care they provide.

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Organisation

The welfare of children and young people continues to be safeguarded and promoted by a rigorous system of monitoring and review. These processes, which are regularly carried out by the manager and separately on behalf of the registered provider, are robust. They ensure that where shortfalls are found, they are highlighted and addressed quickly. Scrutiny of documents from these processes are made available to staff, as are Ofsted inspection reports the information from which is used effectively in the home's quality assurance system. An established system of forward planning, reflected in the home's annual development plan, is effective in charting the course to the continuous improvement in children's short break care.

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Organisation

The promotion of equality and diversity is outstanding. This is not only evident in the sound equality and diversity policy, but in the ways it reflects the diversity of community it serves both in the children looked after and staff employed to care for them. Commitment to improving the lives of disabled children is manifest and staff experience and their equality and diversity training ensure that the outstanding care provided responds appropriately to the children's race, religion and culture.

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Organisation

Efficient organisation of the children's records ensures they are kept on a strictly individual basis and include all the information necessary to plan their care and monitor their progress. The procedure for children's and young people's access to their personal records is promoted in the Statement of Purpose. Should access to records be sought, the information is arranged in a way that would make this straightforward.

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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):

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Recommendations

 ensure regular testing of the fire alarm at no less than the minimum frequency recommended by the fire authority (NMS 26.8)  conduct risk assessments specifically in regard to outdoor play equipment apparatus and widows without restrictors above ground level and, as necessary, take action to prevent avoidable risk to the children's safety (NMS 26.2)  ensure that the interior of the home, namely floor covering, is maintained in a good, clean state (NMS 24.3).

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