Children's Home run by Cheshire West and Chester Council in Cheshire West and Chester

Unique reference number SC034849 Inspection date 15/09/2010 Inspector Sharon Lloyd Type of inspection Key

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Date of last inspection 07/01/2010 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 local authority children's home is a purpose-built, single storey building that provides short break care for up to six children and young people with disabilities. The home is situated on the outskirts of a town. It is appropriately adapted to address the needs of those with physical and learning disabilities. It has a very large, enclosed garden. Communal rooms include two lounges, a dining room, sensory room and ball pool. Single bedrooms are available for every child and young person. The home is staffed according to the needs of the children and young people present. The home provides waking night staff.

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Summary

The overall quality rating is satisfactory.

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Summary

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

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Summary

The inspection was unannounced and the home was assessed against the key national minimum standards, the Children's Homes Regulations and the Every Child Matters outcome areas. The organisation of the home was also assessed. Three children and young people participated in the inspection and a further nine contributed through questionnaires.

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Summary

The home provides a good standard of care in all of the Every Child Matters outcome areas. The staff are experienced and suitably qualified and meet children's and young people's needs well. They focus on the individual needs of each child and young person and promote equality and diversity well.

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Summary

Three actions are raised as a result of this inspection, all relate to the organisation and management of the home. Four recommendations are made relating to recording issues, two relate to the premises and one to the provision of play equipment for children with physical disabilities. There is no Registered Manager in post. Ofsted raised an action to appoint a registered manager after the inspection that took place in January 2010 and this remains outstanding.

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Improvements since the last inspection

Three actions were raised following the last inspection and two have been addressed. The oil fired central heating is working efficiently so children and young people are kept warm. Staff members gather children and young people's views each month and record these in 'well-being' forms. These are scrutinised by the manager who takes their views into account when making decisions about the home and the care of individual children and young people. Recognising that the format for gathering this information is not in a communication style that suits all children, the home has developed a pictorial consultation document and staff are planning further improvements. Each month, a selection of parents are also canvassed for their views about the home and they are invited to raise concerns and make suggestions for improvements.

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Improvements since the last inspection

The home was required to appoint a Registered Manager. This action has not yet been addressed and is therefore repeated. An interim manager has been in post for eleven months and is in post until December 2010. Two recruitment campaigns during this time have been unsuccessful. A third is planned to take place within the next few weeks. Although the home is well led by the interim manager, staff remain unsettled by the uncertainties and changes taking place.

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Improvements since the last inspection

Three recommendations for good practice were made following the last inspection and all have been addressed. Staff are suitably trained in the positive management of challenging behaviour, including the use of restraint. A new county wide induction programme has been established for new staff, based on the induction units provided by the Children's Workforce Development Council. The use of colour coding to identify the files of male and female children and young people has ceased.

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Helping children to be healthy

The home provides children and young people with a very good level of support that promotes their health. Staff know which children and young people require special diets and the home provides meals to suit their dietary requirements and their preferences. This means that children and young people receive ample quantities of well prepared, nutritious foods, including food from other cultures. Staff assist children and young people who need help with eating, with patience and care. A parent commented, 'Staff are great at feeding (peg-feed) and administering any relevant medication'. The record of menus is not sufficiently detailed to demonstrate that children receive healthy breakfasts and snacks.

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Helping children to be healthy

The home maintains excellent liaison with health professionals and parents so that it is informed about any changes to prescribed medication and any changes to the health needs of children and young people. Extensive information relating to each individual's health needs is held within their confidential files and is known to staff.

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Helping children to be healthy

Although written health plans are in place and included within the placement plan, these are not sufficiently detailed to demonstrate children and young people's changing health needs and how these are met over time, within the home. Nor are records routinely kept of treatment, such as physiotherapy, that children and young people receive during their short stays. Daily recordings do not always evidence that children and young people have received the support identified to promote their good health. For example, recordings by night staff do not indicate whether children who need attention during the night have received it in accordance with the placement plan. This shortfall does not have a noticeable impact on the care provided to children and young people. This is because staff communicate well with each other and know the children and young people well. The procedures for the storage, administration and disposal of medicines are

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Helping children to be healthy

outstanding. This ensures that children and young people receive the medicines and health supplements they need to promote their health and development. Parents express confidence that the staff are well trained to administer medication safely and know how to deal with emergencies.

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Protecting children from harm or neglect and helping them stay safe

All parents, children and young people who participated in the inspection said the home provides a safe and secure environment. Staff follow very good routines that protect children and young people's privacy and promote their dignity. There is a choice of bathrooms to meet the range of needs of children and young people. Many children and young people need two members of staff to assist them into the bath or shower. Whilst staff are vigilant about promoting privacy, there are no screens or curtains around baths and showers to enhance their privacy. One parent commented, 'Staff are fabulous at showering and handling my daughter'.

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Protecting children from harm or neglect and helping them stay safe

The home provides parents, children and social workers with information about the complaints procedure and actively seeks their views about the home. It gives parents and children the opportunity to raise concerns or make suggestions for improvements. Parents and children express a very high level of satisfaction with the service and very few make suggestions for improvement. There have been no complaints about the home.

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Protecting children from harm or neglect and helping them stay safe

Staff are trained to recognise signs of abuse and know what to do should they suspect a child has received a non-accidental injury or is at risk of abuse. All injuries are recorded in writing and on body maps. Parents are kept well-informed of the home's safeguarding policy. An anti-bullying policy is in place and staff are pro-active in preventing assaults on children and young people by others within the home. No children have been missing from the home. They are well supervised in the garden and on outings so they stay safe.

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Protecting children from harm or neglect and helping them stay safe

Security of the home is prioritised so children and young people are kept safe from intruders. Staff use a keypad system on external doors. This means that no children and young people can leave the premises without staff. Parents find this procedure reassuring as it protects their children and young people from the risk of harm. However, it does not take into account the needs of those children and young people who are approaching independence and may be ready to go out, alone.

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Protecting children from harm or neglect and helping them stay safe

Highly effective behaviour management strategies are employed so that children and young people are kept safe without the need for sanctions or restraint. The staff team has been trained to use positive methods of control and to use restraint only as a last resort for the safety of the children and young people or others. There have been no restraints or sanctions used in the home for approximately two years. Routine health and safety checks ensure the home continues to provide safe accommodation. Repairs are attended to promptly and the home is kept clean and tidy. Children and young people are kept safe from potential abusers because all visitors are monitored and good staff recruitment procedures are in place.

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Helping children achieve well and enjoy what they do

The home provides children and young people with a very good level of individualised support. Staff respond attentively to their wishes and needs and are ever alert to the non verbal cues provided by those children and young people who have severely limited or no speech. They know the children and young people well so they can respond effectively to children and young people's needs and ensure that time spent at the home is enjoyable and relaxed.

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Helping children achieve well and enjoy what they do

The home maintains close links with schools and a home/school/children's home diary ensures that important information is passed each day between teachers, parents and staff. One parent commented: 'We have a communication book and I am fully informed in the book about what my child has done on each visit'. Staff visit school before a child begins to receive a short break service and spends time observing the child or young person in school and talking to key school staff. This enables the home to employ strategies similar to those used at school in caring for the child. This promotes consistency of care for children and young people. The home does not have personal education plans and statements of special educational needs for all children and young people. This means it does not have current and up- to-date information about their school progress, achievements and aims.

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Helping children achieve well and enjoy what they do

The home provides a range of activities that children and young people enjoy. A selection of toys, musical instruments and arts and crafts are available and there is a large garden. This includes a sensory garden that is easily accessible to wheelchair users. Swings and go-karts are provided for able-bodied children only so those with physical disabilities do not have the same access to outdoor play equipment as their able-bodied peers. Some parents would like to see more outdoor activities. The home has a well equipped sensory room where children and young people can relax and enjoy music, colour, texture and light in comfort.

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Helping children achieve well and enjoy what they do

The home has a minibus designed for wheelchair users. Many of the staff team are trained to drive it. Children and young people enjoy trips out, including outings to parks, shopping and meals out. The home celebrates Christian festivals and makes children and young people aware of other religious festivals, such as Ramadan and Diwali. It celebrates birthdays and special events including a young person's final visit with a celebratory meal or similar.

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Helping children make a positive contribution

Copies of core assessments and other social work reports provide useful background information for staff and assist the home in identifying children's and young people's needs. Written placement plans identify each individual's needs, including their religious, social and special needs and records how they are to be met within the home. Plans help staff to focus on how to promote their welfare and ensure they cater for children and young people's interests, likes and dislikes. Parents confirm that children and young people enjoy their short stays and are very well looked after by a dedicated and knowledgeable staff team. Children and young people have opportunities to learn about other cultures and to develop interpersonal skills.

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Helping children make a positive contribution

All of those who participated in the inspection were complimentary about the home. Staff are developing the materials they use to ascertain children and young people's views so that those with communication difficulties are better able to make their views and choices known. A parent commented: 'my child doesn't speak but the staff know as well as I do how to communicate with her to find out her wishes/needs'. A visitor from the National Youth Advocacy Service visits the home each month and spends time with the children and young people. He reads the monthly consultation documents and raises any concerns on behalf of children and young people.

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Helping children make a positive contribution

The home has developed very good links with the local community and is well supported in its annual open day. Local groups work with staff, children and young people to raise funds that are spent on additional resources for children and young people. Staff, children and young people are known locally and are made very welcome in the area.

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Achieving economic wellbeing

Children and young people are assisted to develop self-care skills but the opportunities to learn the skills necessary for independent living are limited because children and young people attend for short stays only and many need extensive assistance with personal care. Children and young people do not use the laundry. Only able-bodied children and young people can use the kitchen. With close supervision from staff, they bake cakes and prepare simple meals. However, because of restrictions on the use of the kitchen, they do not routinely learn to prepare hot drinks and snacks in preparation for independence. Staff support those children and young people who bring pocket money to spend it appropriately so that they have the opportunity to shop and pay for goods themselves. Transition to adult services is sometimes delayed and the home is pro-active in lobbying both children's social workers and adult services to develop plans in good time.

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Achieving economic wellbeing

The home is a purpose-built single storey building that is institutional in nature. It has all the adaptations necessary to provide suitable and comfortable accommodation for children and young people with disabilities. The staff team have worked very hard to provide children and young people with a warm and welcoming environment. Bedrooms are pleasantly decorated and child focused. Some have specialist beds to meet the needs of particular children and young people. Communal areas are comfortable and there are special chairs and bean bags to promote children and young people's comfort. The home is well kept and clean. Staff follow good hygiene procedures when assisting with personal care so children and young people are protected from germs. Some bathrooms are large and clinical, with suitable equipment for those with physical disabilities. Others are smaller and domestic in style. These can be used by able-bodied children.

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Achieving economic wellbeing

With the aid of the local community, staff have raised funds to improve the facilities available to children and young people. For example, they have redeveloped the sensory room so that it provides a relaxed, yet stimulating environment which children and young people enjoy.

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Organisation

The home operates in accordance with its Statement of Purpose, which was reviewed and updated in June 2010. However, the statement does not contain details of the staffing arrangements for the home so this information is not readily available to parents and social workers. All policies and procedures have been renewed within the last 12 months to ensure they accurately reflect the service provided.

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Organisation

The home has been without a registered manager for a year. An interim manager currently leads the long-standing and dedicated staff team. A typical parent comment is: 'The staff are wonderful and friendly'. Children and young people are looked after by staff who receive supervision from a senior member of staff every month, except where staff holidays and sickness prevent this. This means that staff receive satisfactory supervision and guidance in their work. Plans to improve the format of supervision sessions have been agreed and will commence shortly. Approximately 85% of the care staff are suitably qualified and experienced to meet the needs of the children and young people.

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Organisation

A rolling programme of staff training has been developed and staff have begun attending long overdue refresher training in core areas. This means that staff are renewing and developing their skills so that they work more effectively with children and young people. The home is staffed in accordance with the needs of the children and young people on short stays. This ensures that there are sufficient staff on duty to meet their needs. Good consistency of staffing and continuity of care is achieved because staff turnover is very low. This means that children and young people are looked after by carers they know.

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Organisation

Local authority councillors visit the home each month and report on the standard of care provided. This report is made available to the manager of the home and actions for improvement are noted and addressed. The manager monitors the operation of the home and produces a report and an action plan to address any shortfalls each month. This ensures that the home continues to provide a satisfactory level of care and continues to improve through regular monitoring and review of practices.

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Organisation

Children and young people's confidential information is kept securely. Daily records are maintained but these do not always provide sufficient detail to evidence that they are addressing children and young people's needs in full. Although most of the required information is held in relation to each individual, there are some shortfalls. Not all files are kept in accordance with Schedule 3 of the Children's Homes Regulations and the national minimum standards. For example, visits from professionals are not always listed in confidential files. Although electronic monitoring is used with a number of children and young people who may need attention at night, permission for this has not been obtained.

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Organisation

The promotion of equality and diversity is good. One parent reported, 'my child is helped to understand about different disabilities and how to cope with other children whose needs are different to his'. The staff team are sensitive to children and young people's individual special needs. They make sure that each child and young person is cared for appropriately and that all enjoy their time at the home. By providing specialist equipment and furniture, the home makes sure that every individual has the opportunity to relax in their own particular way. Wheelchair users have the same opportunities for outings as able- bodied children and young people because the home has a large, adapted minibus. However, play equipment in the garden is restricted to able-bodied children and young people only.

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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

34 submit a registered manager's application to Ofsted in line with the requirements of the Care Standards Act 2000, Part II, section 11 (Regulations 7 and 41) 31/01/2011

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Std. Action Due date

35 ensure that you have the placing authority's consent to the use of electronic monitoring and that it is agreed in the placement plan (Regulation 22) 29/10/2010

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Std. Action Due date

35 ensure children's files are kept in accordance with schedule 3 and that all visits to the child are recorded, demonstrating any treatment they receive from specialist health workers. (Regulation 28) 31/12/2010

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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

 improve the record of menus so that it demonstrates compliance with Regulation 13 (NMS 10.4)  improve recording so that it accurately reflects the level of care provided (NMS 35)  consider installing curtains or screens around baths and showers to maximise privacy and dignity (NMS 25.5)  make sure that children who are able to leave the premises safely without staff, are not prevented from doing so by the security measures in place (NMS 23.9)  ensure personal education plans, copies of Statements of Special Educational Needs and other records relating to education are held on children's confidential files (NMS 14.2)  provide disabled children with the same opportunities for outdoor play as able- bodied children, for example, through the provision of specialist swings (NMS 15.2)  set out the home's staffing policy in the Statement of Purpose and include the information listed in Schedule 1 of the Children's Homes Regulations (NMS 30.2)

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