Children's Home run by North East Lincolnshire Council in North East Lincolnshire

Unique reference number SC367802 Inspection date 07/09/2010 Inspector Fiona Parker Type of inspection Key

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Date of last inspection 23/03/2010 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 offers care for children and young people aged between five and 17 years with physical and/or learning disabilities. The home forms part of the children's disability service and provides care for children or young people that have been assessed as requiring this service.

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Brief description of the service

The bungalow is a purpose-built facility, situated close to a town and provides accommodation for two children or young people of either gender receiving shared or long-term care. Bedrooms are single occupancy and there is a wet room with shower, toilet and electronic changing bed. Bathrooms and bedrooms have hoist equipment installed. Other facilities include a lounge with dining area, a fully fitted kitchen which is domestic in style and a conservatory.

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Brief description of the service

The home is situated within the community and close to shops, sports facilities and other recreational areas. The home has shared use of a minibus. The home is complemented by a secure, garden with play equipment and a summer house.

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Brief description of the service

There are currently three young people receiving a service, with two or one young person in the home at any one time. One young person was staying during this inspection and was observed with staff.

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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 is an unannounced key inspection to assess the key standards under the five outcome areas of Every Child Matters. In addition, key standards which relate to the organisation were assessed. As part of this inspection the progress on the previous recommendations was also assessed.

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Summary

This service was previously judged as outstanding and the exceptional care young people receive has been sustained, resulting in an outstanding overall judgement this visit. Equality and diversity is also judged as outstanding.

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Summary

Young people's welfare, safety and health are fully prioritised and excellent levels of care, support and monitoring ensures their needs are fully met during their stays. The staff team are committed to improving the life chances of young people and broadening their horizons. Excellent individual plans are in place, implemented in practice and regularly reviewed. A particular strength is how each individual young person is fully understood therefore receiving tailored and personalised care and support. Learning, achieving and increasing independence is threaded through all plans and supported in young people's daily experiences. Safeguarding responsibilities are fully understood and robust systems ensure care practice, health and medication needs are monitored and therefore fully accountable.

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Summary

There are two recommendations as a result of this inspection relating to minor points which do not impact upon young people.

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Improvements since the last inspection

Action has been taken on two recommendations from the previous inspection. A system is in place to ensure any sanction resulting from an incident is recorded in a sanctions log. Since the last inspection the number of staff achieving the required qualification has increased. Further staff will achieve this in the near future. Therefore, all achievable action has been taken and this recommendation is not repeated.

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Helping children to be healthy

Excellent arrangements are in place to promote healthy outcomes for children and young people. Robust individual health plans ensure staff are guided on all aspects of health and development. Specialist health professionals, along with parents, are regularly consulted, involved and lead in reviewing health needs. Staff implement agreed emergency and planned invasive medical plans, where appropriate. This ensures prompt action can be taken in response to potential health issues. An example of this was an updated plan not on a file was quickly rectified and forwarded from the looked after nurse. Staff's excellent knowledge and relationships with children and young people ensure any health changes are very quickly identified and action is taken. As a result children and young people receive a holistic approach to their health care from staff who are very well trained to support individual health needs.

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Helping children to be healthy

Children and young people's medical health needs are exceptionally well met. Arrangements for medication are robust and supported by very clear policy. Safe practice is in place to administer, store and record medication. Excellent records ensure accountable practice including records to monitor medication leaving and coming into the home. Plans clearly detail medication needs and medication is administered as prescribed. Excellent information ensures staff understand the use of each medication and the reasons this is prescribed. As a result this informs staff and increases their knowledge of the care each individual child or young person needs. Children and young people are given choices wherever possible, for example, choosing which medication they want to take first.

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Helping children to be healthy

Children and young people are fully supported to lead healthy and active lives. Healthy eating and making choices are routinely promoted in the home. Their daily food intake is recorded to monitor their diet and ensure this is nutritious. This is a shared responsibility between school, parents and the home. Parents are frequently consulted and their views and wishes form part of health plans. Special diets are routinely incorporated into menus, as are children and young people's individual likes and dislikes. Healthy snacks are readily available and any sweet intake is supported to ensure the quantity is not excessive. Children and young people are able to regularly make choices about foods and have some say over their daily diet. Frequent trips to local supermarkets enable children and young people to shop, choose and pay for foods. In addition, staff encourage them to help prepare snacks and meals with their structured support. Physical health and exercise is promoted

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Helping children to be healthy

through various activities and outings. Overall there are excellent outcomes in health and welfare for children and young people.

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Protecting children from harm or neglect and helping them stay safe

Children and young people's safety and welfare is a priority in the home; as a result children and young people benefit from an excellent level of care during their stays. Staff are acutely aware of respecting privacy. For example, staff ensure that children and young people can make choices about their bathing arrangements and the support they need. Private time and space is actively encouraged so children and young people can develop independently of the direct support of staff.

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Protecting children from harm or neglect and helping them stay safe

Excellent opportunities are in place for children and young people to express themselves. Staff are committed to ensuring children and young people's rights to complain, express dissatisfaction or happiness are part of daily practice. In addition, staff interpret and advocate children and young people's views from their robust knowledge of each individual. Inclusive complaints and bullying information ensures children and young people are informed about such rights, in line with their understanding. All plans include individual welfare guidance for staff to ensure consistent and safe practice, for example, the impact on children and young people of physical intervention. Accurate records demonstrate staff are pro-active and follow diversion techniques to avert behaviours. As a result, thorough records show no complaints, restraints or sanctions have been used in the home from the previous inspection. Good staffing levels and careful consideration of the mix of children and

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Protecting children from harm or neglect and helping them stay safe

young people supports a safe environment.

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Protecting children from harm or neglect and helping them stay safe

Robust positive handling plans guide staff on the agreed strategies to support children and young people with any frustrations and identified behaviours. Creative ways are explored to meet the sensory needs of children and young people and minimise the potential for escalating behaviours from anxiety or frustration. Staff are very well trained in the recognised techniques and effectively implement the strategies in line with plans and policy. Regular and focussed scrutiny from managers ensures practice is consistent and individual to children and young people.

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Protecting children from harm or neglect and helping them stay safe

Safeguarding is a priority, staff are aware of their roles, responsibilities and the reporting procedures. Children and young people's welfare is regularly monitored to ensure their needs are exceptionally well met and practice is accountable. Robust checks for fire, health and safety and evacuations regularly take place. Excellent effort from staff ensures children and young people understand about the risks of fire and the need to practice evacuations. Personal evacuation plans and visual aids support each child or young person to manage this necessary procedure.

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Protecting children from harm or neglect and helping them stay safe

A diligent approach is taken to risk assessments and comprehensive documents demonstrate minimising risk is a careful and well thought out area of practice. Risk assessments cover a variety of potential areas of risk for children and young people, they are regularly reviewed and updated. This ensures children and young people are protected and risk assessments are current, reflecting changing needs.

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Protecting children from harm or neglect and helping them stay safe

Children and young people are suitably protected by the robust system to monitor and vet visitors. The majority of visits for maintenance and business take place when they are at school or their family home. This ensures children and young people's lives are not disrupted unnecessarily. Good arrangements are in place to recruit and select suitable staff. There are no new members of staff since the previous inspection. Records show the service recruits staff with relevant previous experience.

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Helping children achieve well and enjoy what they do

Children and young people benefit from excellent levels of individual support. The staff team are clear on their priority to offer choices, consult with children and young people and advocate on their behalf. This is integral to everyday practice. Each child or young person's individual book identifies their personal likes, dislikes, wishes and feelings in detail. It is clear each child or young person is understood very well as the consistency in their overall information supports this. Staff are fully committed to improvement and frequently analyse each child or young person's individual progress to consider new ways of working. Key workers take responsibility for records, updates and liaising with professionals; as a result files are thorough and well documented. Specialist support is provided for sensory and emotional needs which forms part of individual plans and strategies.

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Helping children achieve well and enjoy what they do

Children and young people benefit from individual education provision and packages of support as a result of assessments of need. Excellent liaison between parents, staff and education ensures consistency and that information is well shared on a regular basis. Staff, with parents advocate for children and young people on suitable education provision during times of transition. Individual and personal education plans are robust and detail targets, aims and objectives. Regular reviews share information and update targets. Education is viewed in a wider 24 hour learning culture. The importance of achieving is celebrated and as one staff member put it 'moving young people forward' represents the ethos in the home. Excellent opportunities for learning are promoted throughout children and young people's stays through activities, outings and daily interaction with staff. Praise for achieving small steps, such as overcoming a difficult aspect of daily life are recognised and

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Helping children achieve well and enjoy what they do

positively reflected to children and young people. As a result children and young people have full opportunity to progress and achieve their individual potential.

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Helping children make a positive contribution

Children and young people's complex needs are thoroughly assessed and detailed in robust plans. A multi-agency approach ensures parents, specialists and all involved professionals contribute and share knowledge for the benefit of children and young people. Regular reviews, including statutory reviews, ensure progress, needs and plans reflect children and young people's development, changing needs and future support. Plans are agreed and this is evident in most, but not all plans contain signatures. In addition, staff regular request overview or consult with others in between planned meetings. This demonstrates a pro-active approach and the commitment to ensuring needs are fully met and in line with children and young people's individual needs and progress. Excellent detailed daily and weekly records chart children and young people's progress and development and promote accountable practice. As a result children and young people using this service benefit

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Helping children make a positive contribution

from a pro-active staff team working closely within a multi-agency team.

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Helping children make a positive contribution

Children and young people share their time between the home and with their parents. Frequent contact and updates between parents and staff reflect a joint approach to providing care. Staff support parents and children or young people with significant events or appointments during the times of their stay at home. This is excellent practice.

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Helping children make a positive contribution

Children and young people are supported to move into the home in a planned and structured way which supports their individual needs. Communication systems, introductory visits and guidance from specialists all support introductions, as appropriate. Transition planning supports young people's transfer to adult service support. Staff are pro-active in engaging with adult services, arranging meetings and visits. Staff advocate strongly on behalf of young people to ensure their needs are assessed and understood in the early stages of the transition process.

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Helping children make a positive contribution

Exceptional measures to gain children and young people's wishes and feelings are part of the ethos of the home. Staff strive to create a relaxing and stimulating environment. Children and young people's views, wishes and feelings are routinely sought on day-to-day life, activities and outings. In addition, staff check children and young people are feeling comfortable, happy and genuinely enjoying their stay. Wishes and feelings books show children and young people's preferences on a range of their needs to support them, reduce potential anxiety and guide staff. In addition staff advocate on fairness and ensuring equal opportunities for each child or young person. For example, staff ensure each child or young person has a computer as per local authority policy. Parents are frequently consulted and voice their independent views on their children's care and experience. Formal consultation through questionnaires is a recent development to improve the opportunities for parents to

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Achieving economic wellbeing

Independence is an integral part of daily plans in the home and the approach to independence is in the wider sense, to increase children and young people's everyday skills. Each has daily individual strategies to work on with the support of staff. Plans are clear, in line with assessed abilities and reviewed to monitor progress. Children and young people benefit from the structured approach to supporting them achieve goals; as a result progress, for example, with personal care is achieved. Staff are committed to improving opportunities and providing consistent support to increase children and young people's sense of independence and control.

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Achieving economic wellbeing

The majority of children and young people will leave the home to receive longer term support from adult services. As a result staff are pro-active in building strong relationships and partnerships with through care and adult services teams to advocate for children and young people. Staff are fully committed to informing on- going assessments from their detailed knowledge of the child or young person's history and development. Transition meetings and formal pathway plans are in place to prepare children and young people and support a smooth transition to adulthood. Staff support parents with visits and introductions to future services, where required. Staff are flexible and there is commitment within the local authority to move at a pace which is right for the children and young people. Excellent practice from the staff team supports children, young people and families during this sensitive time in their lives.

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Achieving economic wellbeing

Children and young people live in a spacious and well-designed home which is adapted to suit their needs and level of care. Rooms including bedrooms are light and airy with appropriate privacy at windows. Attention to creating a homely environment is evident with photographs, ornaments and personal possessions. Children and young people are able to make choices about which room to spend time in, including the privacy of their bedroom. Easy access to a safe garden and summer house extend the choices for children and young people. A range of play equipment, sensory toys and DVDs enhance learning, familiarity, entertainment and distraction as required to meet their needs. A staff member commented the intention for children and young people is to 'open their world' during stays.

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Organisation

The promotion of equality and diversity is outstanding. Excellent individual care is offered to each child or young person as a result of thorough assessments which fully address personal, social and learning needs. There is a strong commitment to supporting children, young people and parents during home stays. This ensures children and young people can fully take part in family life and benefit from religious events or important family occasions. As a result they are included and benefit from social gatherings. Staff have developed and effectively use children and young people's preferred communication methods to support their choices and preferences in daily life. In addition, measures are in place to reduce times which could cause anxiety such as ensuring personal plans, and visual methods for fire evacuations. Good communication is in place with parents and professionals to assess, review and update plans. This ensures children and young people's complex needs benefit from

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Organisation

a multi-agency approach offering different perspectives and experience.

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Organisation

A user-friendly Statement of Purpose reliably informs parents and professionals of the aims, objectives and service this home provides. What to expect and how to access services is very clear. A well-designed children's guide in a suitable picture method supports children and young people's admission to the home. Particular attention to their rights, information on bullying and complaints is in detail.

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Organisation

Staff feel very well supported, valued and listened to. They receive regular supervision, informal support and have up-to-date appraisals. Regular team meetings ensure children and young people's needs are the focus and individual strategies are discussed. This ensures the practice as a team is scrutinised. Staff receive a wide range of relevant training to provide safe care and almost all have completed the National Vocational Qualification at level 3 Caring for Children and Young People. The required number will be met this in the very near future.

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Organisation

Effective management monitoring is a regular and organised activity within this home and as part of the overall disability service. As a result, children and young people's progress, development and care is regularly and thoroughly scrutinised to ensure practice is accountable and meets procedures and policy. This system ensures senior managers are very aware of the day-to-day issues with each child or young person, as such providing levels of protection for vulnerable children or young people. Independent visits take place monthly and reports are forwarded to Ofsted as required. Although these meet the regulation, the service plans further development to improve the visits. Overall there are excellent systems, safe and confidential arrangements for files in a very well-managed service.

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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 each child has a clear health plan. In particular this relates to ensuring the latest health plan complied by the looked after children nurse is on young people's file (NMS 12.2)  frequently seek the views of children and parents on the content and implementation of the placement plan. In particular this relates to obtaining parents and social worker's signatures on behaviour management plans (NMS 2.5)

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