Children's Home run by Anna House Limited in Havering

Unique reference number SC058603 Inspection date 21/01/2011 Inspector Joanna Heller Type of inspection Key

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Date of last inspection 13/10/2010 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 home is a respite care unit for five children and young people with physical and learning disabilities. The building is a detached, adapted house situated in a residential area. The home has five single bedrooms. Communal facilities include a lounge, kitchen and conservatory all of which are well decorated and maintained. The rear garden is secure and in regular use. The home is close to the local shops and is supported by good local transport links. The service provides support to a small group of families at this point in time and places are purchased via the child's local authority.

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Brief description of the service

Young people and children have packages of care varying from every weekend to occasional overnight stays. No young people were receiving care at the time of the inspection.

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Summary

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

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Summary

This was an unannounced key inspection carried out as part of the annual inspection programme. All key standards were reviewed. The home is graded as good in each of the Every Child Matters outcomes. Children and young people benefit from highly individualised child-focused care, which addresses all their complex needs. Parents say their children enjoy coming to the home and that staff are patient and caring.

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Improvements since the last inspection

At the last inspection the manager was asked to ensure that staff recruitment processes meet regulatory requirements and best practice. Improvements have been made in this area. The manager now ensures that recruitment practices are managed in line with regulatory requirements. However, further improvement is required in order to meet best practice. The manager was also asked to improve the recording of incidents of restraint. Incidents of restraint are now clearly recorded.

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Improvements since the last inspection

As a vulnerable adult over the age of 18 resides in the home the manager was asked to ensure any risks are clearly identified and that staff undertake vulnerable adults training. A risk assessment is now in place and most staff have undertaken safeguarding vulnerable adults training.

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Helping children to be healthy

Children and young people benefit from meals which reflect their dietary needs, and likes and dislikes. Some children and young people have issues such as a very limited diet. Staff encourage healthy eating but also recognise that as a short break service, their primary aim is to make young people comfortable and enjoy their stay. Pictorial menus are in place. Staff enable children and young people to make choices about what they eat through any verbal communication, picture prompts, and knowledge of their likes and dislikes.

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Helping children to be healthy

The home has safe systems in place for the storage and administration of prescribed medication. These are audited regularly by the local pharmacist, who also provides training and guidance to staff. Clear records are maintained of medication given, and of medication coming into and leaving the home.

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Helping children to be healthy

Staff are aware of health conditions that young people have and their impact on the day-to-day care which needs to be offered. Families and foster carers retain the primary responsibility to ensure young people that young people have regular health checks. Staff, however, ensure that children and young people receive any medical treatment they require during their stay. Where health appointments take place during their stay, staff ensure young people attend. Staff receive training in key areas such as food hygiene, first aid and managing epilepsy.

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Protecting children from harm or neglect and helping them stay safe

A pictorial complaints procedure is in place for the children and young people to use but many would need significant levels of support to make a complaint. Complaints would in most cases originate from parents or an advocate. One complaint has been received in the past 12 months, which was managed appropriately, demonstrating that management deal with complaints effectively.

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Protecting children from harm or neglect and helping them stay safe

The nature of young people’s disabilities mean that bullying as such, is not an issue experienced in the home. Staff are, however, vigilant to ensure that any issues of challenging behaviour do not impact on other young people. One-to-one staffing levels and appropriate security arrangements ensure children and young people are effectively safeguarded from going missing. all young people would be highly vulnerable if unaccompanied by an adult outside the home. Staff have received training in safeguarding children and vulnerable adults and are aware of what to do should a safeguarding concern arise.

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Protecting children from harm or neglect and helping them stay safe

Behaviour management in the home focuses on rewarding good behaviour, and keeping children and young people active and busy to prevent boredom. Staff recognise that children and young people use behaviour as a way of communicating and seek to offer alternative means of communication and distraction techniques. Staff use restraint only where young people’s behaviour poses a risk to themselves or others. Physical intervention, in most cases, has consisted of holding a young person's hand to prevent them striking out. Training is scheduled for those staff who have not had breakaway techniques and restraint training. Sanctions, as such, are not particularly effective with the current children or young people due to their limited understanding of consequences.

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Protecting children from harm or neglect and helping them stay safe

The building is well maintained and the provider ensures that risks to children, young people and visitors are minimised through the regular checking of appliances and services. The recent fire risk assessment of the home highlights changes to previous guidance and recommends significant changes in the fire precaution systems in place. As a result of this, management have invested heavily in providing new fire doors and alarms and emergency lighting is to be installed shortly. A number of other tasks, however, remain outstanding. The manager ensures that regular checks and servicing of essential fire equipment takes place.

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Protecting children from harm or neglect and helping them stay safe

Vetting practices meet regulatory requirements, however they do not always follow best practice. For example, references on one occasion were accepted where the referee had only known the applicant for four months. Recording of decisions regarding suitability and other issues is not sufficiently detailed. These issues were discussed with the manager who advised the inspector they would be seeking out 'safer recruitment' training. No staff are employed until checks on their suitability such as identity, employment and any criminal history are carried out.

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Helping children achieve well and enjoy what they do

The children and young people have high care needs due to their various disabilities and are provided with a one-to-one worker each day. Any equipment required in relation young people's disability is provided. All key policies relevant to the children and young people such as complaints and fire are available in pictorial form. Communication systems used by young people are known and supported by staff. Care is highly individualised and child-focused. Risk assessments are in place for children and young people which identify their vulnerability and any risks they may pose to others. Activity based risk assessments are also in place.

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Helping children achieve well and enjoy what they do

All the children and young people attend school on a daily basis and good systems of communication ensure that school, family and the home are in regular touch. Staff are aware of the educational goals for children and young people and strive to help them develop self care skills and understand the world around them. Staff attend key educational events during young people’s stay where parents are unable to do so.

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Helping children achieve well and enjoy what they do

Children and young people benefit from a variety of familiar activities which they enjoy. They enjoy playing in the garden on the trampoline, watching TV, playing games or doing lots of artwork. Young people also enjoy getting out and about in the local community in the home’s mini bus.

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Helping children make a positive contribution

Before agreeing to provide care, the manager ensures that they are clear that the home will be able to effectively meet the child or young person's needs. Only planned placements are accepted. A copy of the central core assessment of need is obtained which is supplemented with the home's assessment process. Children, young people and their families visit the home prior to deciding whether to have respite. Young people are then supported with a gradual transition and introduction into the service including day visits and trial overnight stays. The process is very much led by what is in the young people's best interests.

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Helping children make a positive contribution

From the assessment of need staff develop a individual care plan. The care plan is kept under review through placing authority reviewing processes and by key-workers in the home. Staff enable children and young people to make choices about their lives to the best of their ability. Care plans emphasise the importance of offering choice and recognise children and young people's means of communication.

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Helping children make a positive contribution

Children and young people are supported to make and receive telephone calls and family members are made welcome should they wish to visit.

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Achieving economic wellbeing

Children and young people benefit from a well maintained and welcoming building. They are provided with accommodation, furniture and equipment which meets their needs. Children and young people who are non-ambulant are provided with ground floor bedrooms and an adapted bathroom. Bedrooms are single occupancy and children and young people are able to personalise their rooms with pictures and photos. Communal areas are bright with photographs of the children and young people, and pieces of their artwork adorn the walls. The garden is regularly enjoyed in the summer with activities such as playing ball, or on the trampoline and in the paddling pool. Additional administrative work space is provided in an office in the garden.

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Achieving economic wellbeing

No young people have a pathway plan in place as they are likely to require high levels of support throughout their lives. Staff, however, work with placing authorities on transition plans for young people approaching the age of adulthood. Staff support young people on all levels to develop their independence in areas, such as communication and self care skills.

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Organisation

The provision of equality and diversity within the home is good. Children and young people benefit from highly individualised child-focused care which addresses all their complex needs. Staff provide role models from a wide variety of backgrounds and have had training in diversity.

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Organisation

The Statement of Purpose and children's guide includes key information as to the services provided. The children's guide is available in a pictorial format that is more easily accessible to children, young people and their families.

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Organisation

Staffing levels at the home are high and meet the needs of the children and young people. Young people benefit from one-to-one staff support. Two waking night staff are provided. Staff benefit from regular training in key areas such as autism, challenging behaviour, epilepsy management as well as restraint and child protection. Where training such as first aid or control and restraint are due to be updated, these have been booked. Parents say their children enjoy coming to the home and that staff are patient and caring.

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Organisation

Quality assurance systems in place include visits to the home each month under Regulation 33 and the manager visiting at varying times of the night unannounced. However, these systems are not sufficiently comprehensive to assist the service in clearly identifying ways for the service to grow and improve.

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Statutory Requirements

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

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Std. Action Due date

26 ensure that following consultation with the fire authority, that all recommendations are acted upon (regulation 32) 28/03/2011

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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 that recruitment processes reflect current best practice (NMS 27)  ensure quality assurance systems are sufficiently comprehensive to assist the service in clearly identifying way for the service to grow and improve(NMS 32)

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