Children's Home run by Barnardo’s in Oxfordshire

Unique reference number SC013143 Inspection date 17/12/2010 Inspector Michael Williams Type of inspection Key

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Date of last inspection 21/06/2010 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 service is run by a national charity for vulnerable children. Its Statement of Purpose says that, 'our aim is to provide fulltime and shared care to a maximum of five children/young people whose ages range from 5 to 18 years with disabilities which include learning disability, physical disability and associated challenging behaviour.' It is the only full-time care provision for disabled children in the county. At the time of this inspection, four young people were receiving long-term care at the home and one had just been admitted in an emergency to the home. The home is located not far from the centre of a town and has its own car park and garden area. All accommodation for children is on the ground floor, as are the staff offices.

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Summary

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

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Summary

This inspection was announced shortly beforehand, when the inspector met the Responsible Individual for the home at their sister children's home. It was a full inspection of all the key national minimum standards (NMS) for children's homes. The key findings are that out of the five outcomes for children, two are outstanding and three are good. In addition, the organisation outcome is good and the promotion of equality and diversity is outstanding. Therefore the overall quality rating is good.

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Summary

The outstanding aspects of the service are: the help provided to young people to be as healthy as possible, and to achieve well and enjoy what they do; the support provided to young people with communication difficulties; and the promotion of equality and diversity with young people with learning and physical disabilities and associated challenging behaviour.

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Summary

Good aspects of the service include: the individualised care and support provided to young people; the safeguarding of their welfare; the management of their behaviour; the robust vetting of staff; the communication and partnership between the home, the young people, other professionals working with them, and their parents and schools; the quality of the home's leadership and staffing; and the quality of the staff training.

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Summary

These findings concur with overall comments received about the home. With staff support, four young people completed consultation documents for this inspection. When asked to rate the care at the home, young people's answers ranged from okay, to good, to great. A parent commented, 'handing a child over to be looked after is not easy but the centre has been brilliant in supporting both my child and myself.' Another parent commented, 'overall I am very happy with the service/support we receive from the home. They deal with our family in a very sensitive way.' A placing social worker commented, 'physical and emotional care of the children is very good and of a high standard. There is a definite desire to do the best for the young people. The management and staff are always welcoming and genuinely care for the young people in their care and advocate forcefully on their behalf.'

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Summary

One action and one recommendation, both of an administrative nature, are made to secure future improvement.

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Improvements since the last inspection

The last inspection in June 2010 did not make any actions or recommendations to secure future improvement.

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Helping children to be healthy

Young people enjoy healthy, nutritious meals that meet their dietary needs. Four young people commented positively on the food. One parent commented that their child is 'encouraged to eat healthily'. Another commented that the home has 'done a wonderful job and achieved a good balance of healthy eating' with their child, who 'has been introduced to new healthy foods in a very relaxed way.' Young people's individual food and drink needs are identified and met. They are identified in their 'My Profile' information and met by staff.

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Helping children to be healthy

Young people's good health is promoted as their health needs are very well identified and appropriate action is taken to meet them. All three young people who answered said that someone does look after them when they are unwell. A placing social worker commented that 'the child I work with had a General Practitioner in place within a week of arriving at the centre and a dentist soon after. Healthy living and feeding is promoted.' Each young person's health care needs are clearly identified and recorded and known to staff. Staff are well trained to meet young people's health care needs. The home's sister children's home has a senior nurse who works closely with the home: she was at the home during this inspection.

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Helping children to be healthy

Young people's health needs are also promoted, and their welfare safeguarded, by staff following the home's policies and procedures for administering medicines, and providing first aid and minor illness treatment when necessary. The charity's medication guidelines have been supplemented by local guidelines for the management of medication, to better meet the specific needs of the young people using the service. Medication is securely stored in the home's medication room and administered by staff who have received medication training. The administration of regular and as required medication is recorded and included in young people's individual case files. The home is now keeping a record of this information.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy is well respected and their information is securely stored and confidentially handled. The home has a choice of lounges that young people can use, for example to meet visitors in. Each young person has their own bedroom where they can spend time on their own and they can lock their bedroom door, although staff can gain access in an emergency. Staff at the home follow guidelines for good practice in meeting the intimate care needs of the young people. Young people's information, held in both electronic and paper records, is securely stored.

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Protecting children from harm or neglect and helping them stay safe

Young people and their parents know how to and feel able to complain if they are unhappy with any aspect of the home. The home has a formal complaints procedure and has developed individualised complaints information for each young person, using appropriate communication symbols. Staff can use the latter with young people if they are feeling unhappy about anything. Most commonly these complaints are about other young people's behaviour. Since the last inspection, the home has not received any formal complaints, and only a few complaints from young people that have been appropriately recorded and handled.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected from abuse and an appropriate response is made to any allegation or suspicion of abuse. The home follows their provider's protocol for safeguarding and protecting children. For example, safeguarding is a set agenda item at staff team meetings and in staff supervision. As part of their induction, new staff are required to either undertake on-line safeguarding training or complete a safeguarding induction workbook. Since their last key inspection in June 2009, the home's safeguarding practice has been audited by their provider, and the home has taken part in a Local Safeguarding Children Board scoping exercise for safeguarding disabled children.

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Protecting children from harm or neglect and helping them stay safe

Bullying is known to be unacceptable and staff work hard to counter it. When asked if they get bullied or picked on, two young people said yes and one said no. This was fed-back to the home's manager and is one of the consequences of the young people's challenging behaviour towards each other. As one parent commented, 'the children in the centre can react to different children's behaviour at any time', and this reaction or this behaviour can sometimes be perceived as bullying. The home seeks to counter bullying by paying close attention to the mix of young people living together, by working on a one-to-one basis with them, and by encouraging them to complain about it. This high ratio of staff to young people, coupled with the young people's learning disabilities and the mechanism for opening the home's external doors, means that young people have not been absent from the home without consent.

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Protecting children from harm or neglect and helping them stay safe

Young people are assisted to develop socially acceptable behaviour, through encouragement of acceptable behaviour and constructive staff response to inappropriate behaviour. If necessary, young people have an individual behaviour management plan. It includes details of their behaviour and approved responses, such as the approved physical intervention technique to be used. The home follows their provider's protocol for reporting accidents, incidents, and measures of control and physical interventions used. Any incidents that involve staff using physical intervention and measures of control are then recorded in a volume kept for that purpose. In the last year, 48 incidents have involved the use of physical restraint, as a result of young people's challenging behaviour. The home's records of physical interventions and measures of control do not include every single detail required. An action is therefore made regarding this. Two young people commented that they

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Protecting children from harm or neglect and helping them stay safe

have needed to be restrained by staff. A parent commented that their child's 'key worker actively encourages good behaviour' and that, 'the staff are trained to handle their child's severe behavioural difficulties.'

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Protecting children from harm or neglect and helping them stay safe

Positive steps are taken to keep young people, staff and visitors safe from the risk of fire and other hazards. The home completes and records an individual risk assessment for each young person, looking at key factors, such as their behaviour and communication, and action that can be taken to reduce unnecessary hazards. A fire safety consultant completed a fire risk assessment for the home in September 2010 and the home has acted on its significant findings. The home carries out weekly and monthly fire precautions, for example, monthly fire drills and evacuations. However, the record of fire drills does not include the time they were carried out. A recommendation is therefore made regarding this. Each young person has a personal emergency evacuation plan that addresses evacuation procedures at day and night time. A parent commented that the home 'involved the local fire station and crews' in fire evacuation.

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Protecting children from harm or neglect and helping them stay safe

There is careful selection and vetting of all staff working with children in the home. Staff at the home employed by the charity have been subject to the charity's robust recruitment and vetting procedures. Staff recruitment records are not held at the home but at their head office. They include all of and often more than the information required in respect of people seeking to work at a children's home. For example, generally more than two written references are sought, to cover the applicant's past five years, and these are often verbally verified. The home retains confirmation that the staff recruitment agency has carried out the checks required on agency staff who work with children in the home.

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Protecting children from harm or neglect and helping them stay safe

When asked if they feel safe at the home, the two young people who answered said yes.

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Helping children achieve well and enjoy what they do

Young people receive very good individualised support to meet their particular needs. When asked if they can talk to someone if they are sad, two young people said yes, and one of them asked a member of staff to write 'I can talk to my link worker.' For another young person, a member of staff wrote 'non-verbal, uses signs.' As a result, staff provide a lot of support to young people with their communication difficulties. Young people receive individualised support both internally, from staff at the home and their link worker in particular, and externally, from specialist professionals and teams, who the staff work in close partnership with to meet the assessed needs of each young person. For example, they work in close partnership with the behaviour support service, who write young people's individual behaviour management plans and do individual work with them.

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Helping children achieve well and enjoy what they do

Young people's educational attainment is excellently promoted and supported by the home. When asked if they get help with their school work, the two young people who answered said yes. A parent commented that the home 'totally support their child's education, monitoring and feeding back to me as a parent as well.' All young people at the home attend school during term time. Therefore young people's link workers develop close working relationships with their schools. Each young person has their own home-to-school book, which facilitates two-way communication between the home and young people's schools. When asked if they can look at things written about them, one young person asked a member of staff to write 'Yes, my school book.'

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Helping children make a positive contribution

Young people at the home are appropriately placed there. They have their needs comprehensively assessed, care plans outline how their needs will be met, and these plans are effectively implemented in practice. As most of the young people in the home have communication difficulties, effective methods of communication are a major element of each young person's placement plan, so that the home can support them to become as active as possible in making decisions about their lives. A parent commented, 'I would like to specially mention my child's key worker who has been brilliant with them.' A placing social worker commented on the 'very good communication between myself and the service. The key worker keeps me up to date regularly.'

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Helping children make a positive contribution

Young people's needs and development are reviewed regularly in the light of their care and progress at the home. Review arrangements are detailed in the home's Statement of Purpose. They include statutory, internal and school reviews, and whenever possible the young person will be included in part or all of their review with their parents. If this is not possible, every effort will be made for a young person's views to be sought before the meeting so that they can be raised on the young person's behalf.

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Helping children make a positive contribution

Young people are able to maintain constructive contact with their parents and family. The home's Statement of Purpose has a section on 'Contact/Receiving Visitors'. Young people's permitted contact with their family is maintained by arranged visits, both in and out of the home, and by telephone. When asked if they can contact people important to them, the two young people who answered clearly said yes. A parent commented that, ‘staff always welcome me when I visit the centre or when I collect my child for weekend visits home.' Young people are able to move into and leave the home in a planned and sensitive manner. The month before this inspection, one young person had left the home in such a manner. A few days before this inspection, another young person had moved into the home. They were admitted in an emergency, which is included as a function of the home in its Statement of Purpose, and which limited how planned and

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Helping children make a positive contribution

sensitive the home could make their admission.

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Helping children make a positive contribution

The home actively seeks the opinions of young people, and their families and carers, on the way the home is run, and its systems for doing this reflect the young people's differing communication needs. When asked if they are listened to, all three young people who answered said yes. A placing social worker commented, 'consultation with the young people is seen to be proactive.' The home's consultation with young people is often linked to their reviews. Given the communication difficulties of most of the young people at the home, the home's communication with their parents is vital. The home's effective 'Links with parents' are therefore detailed in its Statement of Purpose. A parent commented that they 'have a fantastic relationship with all the staff, they all care about my child but they also care about me and supporting my relationship with my child.' Another parent commented that, 'levels of communication

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Achieving economic wellbeing

In terms of preparation for leaving care, the needs of the young people at the home are such that they will always continue to need some level of care. Nonetheless, whenever possible the home actively encourages young people to increase their independence skills, and helps them to move on to adult services. When asked if they get help to be independent, the two young people who answered clearly said yes. A parent commented that their child is 'encouraged to be independent' and 'has an understanding about money and is encouraged to have pocket money and manage it.' They added that 'the centre is involved in their child's transition to adult services, providing and communicating information about their child's life and needs.' A placing social worker commented, ‘the young person I work with is quite able and is encouraged to learn independence skills and manage their own pocket money.'

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Achieving economic wellbeing

Young people enjoy homely accommodation, decorated, furnished and maintained to a high standard, and providing adequate facilities for their use. When asked if they liked their bedroom, the two young people who answered clearly said yes. A parent commented, ‘the building is very safe and maintained to a high standard.'

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Organisation

A clear, comprehensive statement of how the home operates is available for those needing this information. It was last updated in October 2010 and includes all the information required. The home's previous key inspection reported that, ‘the recent introduction of short break visits has caused serious problems for the young people on full-time placement.' This is no longer the case as this is no longer a part of the purpose of the home. As a result, changes to the group of young people at the home are much less frequent.

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Organisation

Young people receive the care and services they need from staff that have relevant qualifications and competencies. Staff are sufficient in numbers and experience, and they are well trained. When asked to rate the staff, answers from three young people ranged from okay, to good, to great. A parent commented that, 'the overall training and experience of the staff is of a very high standard.' They added that their child 'is always supervised 1-1 and the appropriate steps are taken to safeguard their child when out in the community.' A placing social worker commented that 'staffing restrictions/shortages sometimes can get in the way of offering choices to the children.' However, at the time of this inspection, nearly two months later, staff recruitment had addressed most of these shortages. The home's Statement of Purpose includes information on the staff team, staff training and the staffing policy. The majority of the staff have a relevant qualification, for example in social work or

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Organisation

the relevant National Vocational Qualification. Staff regularly participate in relevant training to ensure that they can continue to meet young people's needs, in areas such as health, safety and safeguarding.

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Organisation

Young people enjoy the stability of an efficiently run home. A Registered Manager is in full-time day-to-day charge of the home. They are ably assisted by a deputy children's services manager and a senior project worker. One parent commented that, ‘the centre is managed well and professionally, striving to improve.' They and another parent singled out the home's manager in particular for praise.

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Organisation

The promotion of equality and diversity is outstanding. It forms part of the home's Statement of Purpose and is part of the safeguarding induction workbook for staff. The home's promotion of equality and diversity is most evident in the work that they do with young people with learning and physical disabilities and associated challenging behaviour: promoting their dignity and rights, and their inclusion in their local community and wider society.

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Organisation

The care of the young people at the home is monitored and continually improved in the light of information about how it is operating. Each month, the Registered Manager monitors and reports on each of the matters they are required to, identifying issues and actions. This internal monitoring is supported by monthly provider monitoring visits. These visits focus on the Every Child Matters outcomes for children and report any actions recommended and on the status of previous actions. Together this monitoring helps to continually improve the provision for young people.

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Organisation

Young people's needs, development and progress are recorded to reflect their individuality. Young people's individual case files include all the information required. To facilitate shift planning and day-to-day care, on each shift staff are assigned responsibility for a particular young person. This helps to ensure that staff meet young people's individual needs and can report on their individual progress.

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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

22 ensure that the written record of the home's use of any measure of control, restraint or discipline on a child includes all the information required. (Regulation 17 (4)) 31/01/2011

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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

 include the time that fire drills take place in the home's records of fire drills. (NMS 26)

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