Children's Home run by Cornwall Council in Cornwall

Unique reference number SC040491 Inspection date 21/02/2011 Inspector Chris Passmore Type of inspection Key

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Date of last inspection 18/08/2010 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

The home provides short-term respite care for children and young people with a learning disability or combined learning and physical disability. The home operates for five nights each week spanning Wednesday through to Monday morning. Packages of respite care vary in length and frequency. Most children stay for one night at a time but others stay for weekends. Where possible children stay in the room they are familiar with and with children of similar needs and interests. The building is single storey, providing level access. Enclosed play areas are provided outdoors where children receive support to access a range of play equipment.

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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 was a key inspection of a local authority short breaks service carried out over two days. The inspection took account of all the key national minimum standards for children's homes and the outcomes for young people using this service. The strengths of the service are evidenced by the staff group and their understanding of the needs of the individual young people accessing the service. There is a professional but friendly approach to each individual and a continuous process of reflection on practice. There is strong and effective leadership from the Registered Manager and this permeates through the staff group. On the first visit the Registered Manager was not on duty but the standards of care and practice were no less. Staff are mutually supportive and committed to the well-being of the young people in their care. Parents who responded to questionnaires spoke unanimously in support of their confidence in the service and its beneficial outcomes for their children.

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Improvements since the last inspection

There were no recommendations or actions set at the last inspection visit.

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Helping children to be healthy

There are extremely good systems in place to manage ongoing health care and encourage young people to live healthy lifestyles.

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Helping children to be healthy

General health remains the prime responsibility of parents and the staff at the home maintain existing routines to manage individual health. Additionally there is a monitoring role played by staff who report on concerns or observations regarding health to parents and professionals.

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Helping children to be healthy

Individual health issues are well documented and contact with other health professionals is maintained or engaged where required. Staff are suitably trained in first aid and for specific health conditions such as epilepsy and the management of diabetes. There are extremely robust checking arrangements around the receipt, storage and administration of individual medication. Any discrepancy is checked out with parents and resolutions agreed before staff will finally accept responsibility.

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Helping children to be healthy

Healthy lifestyles are promoted through physical activities as well as stimulating games and sensory equipment. Personal health and hygiene is promoted through identified areas of need and supported through gentle prompting using relevant communication methods.

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Helping children to be healthy

Where intimate personal care is required there are individual assessments with clear guidance to staff on how such tasks are to be managed. The dignity and privacy of the individual is considered paramount along with the security and safety of the staff managing the task.

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Helping children to be healthy

Healthy eating is encouraged through a variety of well balanced meals and snacks provided by staff. Individual likes and dislikes as well as dietary needs are well documented and staff research ways of meeting these individual requirements while maintaining reasonable catering arrangements. Specific eating requirements in terms of diet or equipment are dealt with in a sensitive and practical way. Staff and young people have mealtimes together around a family style dining table. These are social occasions with chatter and good humour. They are also learning experiences where staff use gentle teaching and prompts to encourage social skills and enhance individual ability.

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Protecting children from harm or neglect and helping them stay safe

Staff respect young people's privacy and dignity. These principles are reflected in a set of rules for the home devised by young people and staff together. These include staff knocking on bedroom doors and young people not going into each others bedrooms. There are guidelines in place regarding the use and storage of young people's mobile phones and those of staff. These do not prohibit young people from making calls either using their mobile or the land line but are designed to protect and safeguard young people.

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Protecting children from harm or neglect and helping them stay safe

There have been no recent complaints at the home. The complaints policy is easily accessed by adults. A simplified version is available to young people using signs and symbols. A key worker system is in place which also enables young people to express their views to staff.

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Protecting children from harm or neglect and helping them stay safe

Staff work positively to protect young people and to promote their welfare. Training updates in child protection are in place. Training includes specific references to young people with learning disabilities. Staff are clear about how they respond to issues and there are good links into the local safeguarding teams. Body maps are used as recording tools and any incidents, occurrences and accidents are recorded. Each of these is considered by the manager before signing off and contributes to effective monitoring and protection for young people.

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Protecting children from harm or neglect and helping them stay safe

Staff reinforce positive relationships between young people. Careful consideration is given to the group dynamic at the point of admission. High staffing ratios provide staff with the ability to monitor individual young people and intervene early to divert any conflicts. The team work with young people to develop positive group relations thereby reducing the potential for any bullying. A counter bullying policy is in place but it is generally not an issue for young people using this service.

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Protecting children from harm or neglect and helping them stay safe

This is a joint agency protocol with the police covering action to be taken in the event of a child going missing in care. However, there have been no such occurrences. Young people are well supervised both inside the home and when out in the community. Suitable risk assessments have been made and arrangements put in place to ensure each young person has the opportunity to enjoy as wide a range of experiences as possible while being kept safe.

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Protecting children from harm or neglect and helping them stay safe

There are very robust assessments and strategies in place regarding individual behaviour management. Physical interventions are rarely used at the home and when they are used they are usually along the lines of caring guides and diversions. The approach to behaviour management is outstanding and demonstrates a commitment to de-escalation and diversion. Staff still receive regular refresher training in physical interventions. The use of sanctions is minimal. Positive modelling, diverting and developing communication are used to help young people develop socially acceptable behaviour.

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Protecting children from harm or neglect and helping them stay safe

Generic risk assessments are in place and include risk assessments of the building. Equipment such as hoists and lifts are regularly serviced. A fire safety risk assessment is in place and the fire detection system and fire fighting equipment are regularly serviced and maintained. Good arrangements are in place for the regular maintenance and servicing of mains services, installations and equipment by professional contractors. A separate inspection of recruitment and staff records was made at the service provider's headquarters in October 2010. This showed the recruitment system to be sound and in line with legislation. All visitors to the home are identified and signed into the visitor’s book before entering the building.

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Helping children achieve well and enjoy what they do

Young people receive individual support in line with their needs. They are well supported through the home's key worker system. Staff demonstrated a detailed knowledge of each young person receiving care. They are clearly able to relate to each young person and adapt their approach to individuals accordingly. Responsibility for the day-to-day issues surrounding education of the young people using this short breaks service remains that of the parents. However, staff continue to develop positive links with local schools. Staff have linked in with school to observe practice in order to support education and care. They also attend education reviews and encourage school representatives to attend the service reviews.

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Helping children achieve well and enjoy what they do

Staff are keen to ensure that young people enjoy their time and the home. Young people are provided with excellent opportunities for social and leisure development. Staff work hard to provide young people with activity choices they enjoy. Staff strive to ensure that young people have opportunities to engage in a wide range of leisure activities within and outside of the home. Activities are provided on a group and an individual basis. The manager is mindful of creating a positive group dynamic through the admissions process, so that children have the opportunity to develop as a part of a social group. At the home, young people enjoy a huge range of toys and games, arts and crafts, television, a computer and sensory room. Outside there is a well-equipped play area, soft football pitch, wheelchair swing, trampoline, playhouse and more. Young people engage in off site activities which include local walks,

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Helping children achieve well and enjoy what they do

cinema, bowling and day trips. All activities are risk assessed and take place according to the needs of the young person.

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Helping children make a positive contribution

Each young person has a care plan which sets out their needs and contains good, detailed guidance that staff need during each short break stay. Where required these contain carefully considered individual behaviour plans that are regularly reviewed. Such plans outline triggers to behaviour and suitable strategies to prevent or reduce escalations in behaviour.

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Helping children make a positive contribution

Young people have their needs monitored and reviewed effectively. The Registered Manager and the key worker attend education reviews, hold in-house reviews and use the provider's electronic database effectively. Review notes are held on files and care plans adjusted in line with any action points set.

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Helping children make a positive contribution

The home's admissions procedures are excellent. New introductions to the home are managed carefully and sensitively. The majority of admissions are planned and emergency admissions are rare but may occur in response to a crisis situation. Although the home is able to cater for a wide variety of need the manager is very clear about the remit of the service and the type of needs the staff are able to meet. The mix and needs of existing groups are balanced to provide optimum opportunities for young people. Admissions are dealt with flexibly and paced according to the individual. Young people may make drop-in visits, stay for tea or have a day visit prior to an overnight stay.

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Helping children make a positive contribution

There is good consultation between staff, young people and their families over key decisions. The staff provide support to families and individual family circumstances well. There is a good level of communication between parents and staff. Staff value the opinions of parents and work in conjunction with them where possible. Staff place importance on developing communication with young people in order to improve their means of listening and interacting. Signs and symbols are used as communicators in a variety of forms, according to the needs of each individual. Young people are consulted and given choices on an ongoing basis. For example, staff always enable young people to choose what they would like to eat and which activities they would like to be involved in. Each young person has a key worker who they can link with.

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Achieving economic wellbeing

Young people are encouraged to be as independent as possible in areas of self care and social skills. This varies to a tremendous degree according to individuals but there is anticipation that each young person can achieve some degree of skill and express their wishes. As young people move towards their adulthood young people are involved with other professionals who guide them towards transition. There is a good liaison between staff at the home and transition workers who often visit the young person while in respite.

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Achieving economic wellbeing

The building provides the space and facilities that young people need to enjoy their short break stays. There are six bedrooms; all have en-suite facilities or are within close proximity to a bathroom. Two bedrooms have electronic over-head tracking hoist facilities linked to an adjacent bathroom. The home is on a level access throughout.

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Achieving economic wellbeing

Communal areas include a lounge, dining room, conservatory, sensory room and a computer room. The kitchen facilities include a variable height work surface and a sink for young people using wheelchairs. Other facilities include a front entrance conservatory, an office and a duty office/sleep-in room with an en-suite shower room for staff use. There is a car park at the front and a large enclosed garden at the rear with hard and soft play areas and lawn. The interior décor is soon to be refreshed and young people were making their colour suggestions for rooms during the inspection visit. Externally work has started on refurbishing the decorated surfaces.

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Organisation

The Registered Manager provides strong leadership and management, ensures there are robust monitoring systems in place and empowers staff to act on their own initiative. Staff are committed and enthusiastic about their roles and state they are well supported through training, supervision and team meetings. The approach to management is one of enabling and encouraging the staff team to develop their skills. This in turn has fostered an ethos of continuous improvement. Staff are keen to take on additional roles and responsibilities assisted and are supported by the manager. Staffing levels are usually set at four team members during the waking day when young people are in the house. By night there is one waking night and one sleeping night staff. These arrangements are flexible and can be changed in response to particular needs. For example additional night sitters have been used for particular situations. The staff team is well-established with minimal turnover. They are

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Organisation

responsive, motivated and demonstrate a willingness to find new and creative approaches to care practice. Agency staff are sometimes used but as far as possible the home uses the same agency workers so that young people have a consistent team.

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Organisation

There is an ongoing programme of induction, training and development opportunities for staff. Training includes child protection, physical interventions, epilepsy awareness, moving and handling, first aid and handling medication. Training opportunities are monitored through the supervision process and staff are enabled to attend training outside the main programme should they show an interest. New staff under go an induction process which is comprehensive and meets approved standards. New staff are also mentored by an experienced member of staff.

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Organisation

Children's files contain sufficient information to ensure that the home can provide efficient care and these are held securely in a locked cabinet.

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Organisation

There are diligent systems in place to monitor the home's performance. The manager oversees the relevant log books and effectively manages performance and practice at the home. A system of regulation 33 reports is also in place.

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Organisation

The promotion of equality and diversity is outstanding. Staff promote equality of opportunity in terms of access to facilities and service for young people with a range of physical and learning disabilities. The team understand the differing needs of the young people they work with and develop an understanding of different disabilities and the barriers these represent for young people. Staff have developed their ability to communicate with young people in order to listen to their needs and wishes. The manager ensures that the service remains flexible enough to cater for diverse and individual needs ensuring that young people who may require a smaller group situation are not prohibited from using the service. Cultural and religious needs are set out in young people’s placement plans.

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