Children's Home run by Lifeworks Charity Limited in Devon

Unique reference number SC003792 Inspection date 25/05/2011 Inspector Paula Lahey Type of inspection Full Provision subtype Children's home

p.1

Date of last inspection 10/01/2011 Website: www.ofsted.gov.uk

p.1

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.

p.2

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 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

p.3

About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

p.3

The inspection judgements and what they mean

Outstanding : a service that significantly exceeds minimum requirements Good : a service that exceeds minimum requirements Satisfactory : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

p.3

Brief description of the service

The service is a purpose built respite and residential service, situated in a rural area. It is registered to provide eight respite and two long-stay residential places for children and young people aged between three and 18 years old who have learning disabilities and may also have physical disabilities. The long-stay places are in a separate, self-contained area of the building.

p.4

Brief description of the service

The accommodation is provided on two floors and a passenger lift is provided for the children to reach the first floor. All bedrooms are single rooms and there is plenty of communal space provided. The service benefits from being situated next to a school that many of the children who use the service attend. The children have the use of the school playing fields and hydro-pool.

p.4

Overall effectiveness

The overall effectiveness is judged to be satisfactory .

p.4

Overall effectiveness

This service provides a homely and supportive environment with a committed staff team who aim to ensure that the children and young people have a good time during their short break visit.

p.4

Overall effectiveness

Children are valued as individuals; their needs are carefully assessed, and a personalised package of care and support is provided. However, documentation maintained does not effectively support this and care plans are not all of a high quality. Managers recognise this and have started an improvement process. Children are happy and settled in their environment and they benefit from positive and relaxed relationships with members of staff.

p.4

Overall effectiveness

A number of areas that require addressing in order to improve the quality of service provided have been identified. These relate to the Statement of Purpose, the process for the monitoring of the service, seeking the views of children and observing the care provided in order to fully identify the strengths and weaknesses. The service needs to maintain effective quality assurance systems in order to formalise a development plan. A previous requirement concerning implementing a policy detailing how the service manages control, discipline and restraint has not been fully met and subsequently continues. In addition, it is recommended that the home implements a policy detailing the use of listening monitors and how these promote children's welfare. There are some weaknesses in the recruitment procedures.

p.4

Overall effectiveness

Staff have additional training needs relating to autism and bereavement and formal supervision is not provided consistently, with the timescales detailed in the service policy. Documentation is not regularly reviewed and kept up-to-date, this is particularly in regards to risk assessments.

p.4

Overall effectiveness

The service demonstrates a capacity to improve. This is evident from the proactive approach taken to address the requirements and recommendations from the previous inspection and although they have not been fully met there has been good progress made.

p.5

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 person(s) must comply with the given timescales.

p.5

Reg. Requirement Due date

17B (2001) The registered person shall prepare and implement a written policy which sets out (a) the measures of control, restraint and discipline which may be used in the home and (b) the means whereby appropriate behaviour is promoted in the home (Regulation 17B) 01/07/2011

p.5

Reg. Requirement Due date

(2001) ensure that the person carrying out regulation 33 visits shall observe the care provided, the practice of staff and (a) interview children accommodated, their parents, relatives and persons working at the home in order to form an opinion of the standard of care provided in the home (Regulation 33) 31/07/2011

p.5

Reg. Requirement Due date

(2001) ensure that the statement of purpose includes all the matters listed in Schedule 1, in particular that arrangements for promoting the behaviour of children, the education of children and the arrangements for consulting with children is documented (Regulation 4) 01/07/2011

p.5

Reg. Requirement Due date

(2001) ensure that the registered manager maintains a system for improving the quality of care provided. (Regulation 34) 31/07/2011

p.5

Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

p.5

Recommendations

 ensure that there is a written policy that sets out how listening monitors should be used, how they promote the welfare of children, how children will be informed of their use, how legitimate privacy of children will be protected and how children will be protected from potential abuse of such measures (NMS 10.5)  ensure that staff are equipped with the knowledge and skills required to meet the needs of children. In particular this relates to supporting children who have autism and experiencing bereavement and loss (NMS 18.1)  ensure that all recruitment records consistently demonstrate that statutory requirements are met, in particular ensure that written gaps in employment are recorded and that all references are verified (NMS 16)  ensure that children's records; particularly behaviour support plans and care plans; are up to date, fully document children's assessed needs and how they will be addressed and contribute to an understanding of the child's life (NMS 22)

p.5

Recommendations

 create an effective development plan detailing how the service will address identified areas for improvement (NMS 15.2)  ensure that all staff receive regular formal supervision and a record is kept detailing the time, date and length of each supervision (NMS 19)  ensure that risk assessments are regularly reviewed. (NMS 10.8)

p.6

Outcomes for children and young people

Outcomes for children and young people are good .

p.7

Outcomes for children and young people

Staff work in partnership with parents and professionals to assess children's needs prior to accessing the service. Together they draw up care plans, protocols and agree a package of care.

p.7

Outcomes for children and young people

Children have a tailor-made transition which includes visiting the service to meet staff and joining in with activities before building up to an overnight stay; this helps to develop children’s confidence and trust in the staff. The service demonstrates a flexible approach to accommodating requests for specific stays and the staff team ensure a balance of need and appropriate peer group.

p.7

Outcomes for children and young people

Children’s diverse health needs are met, and this contributes to children enjoying a healthy lifestyle. Examples include; health intervention protocols, competency training for staff, and the provision of healthy food and positive activities. Children’s individual preferences and dietary requirements are catered for in addition to the daily menu offering balanced options at all meals. Mealtimes are a relaxed and social occasion where children are offered appropriate help in a sensitive and discrete manner whilst ensuring that independence, choice and experimentation of new foods is promoted. Staff encourage and support children and young people with their personal hygiene and the development of independent skills in dressing, eating and drinking.

p.7

Outcomes for children and young people

Children receive full time education and the organisation promotes good communication between the school and the service. This is further supported by the manager meeting regularly with the local school and attending reviews as appropriate.

p.7

Outcomes for children and young people

This service has the resources to provide a range of activities in-house and the use of a minibus to access the community. There are lots of trips out to local parks, swimming pools and local places of interest. The team ensures that children experience a variety of social and leisure opportunities.

p.7

Outcomes for children and young people

Children benefit from well established relationships between the service and parents. Key workers support children to maintain contact with parents during their stay and also complete communication dairies to ensure a shared understanding of children’s daily lives. Parents speak very positively about the service and comment ‘the staff are very friendly and caring’ and ‘ Robins has been a great support and help to our family in providing respite for a very challenging child.’

p.7

Quality of care

The quality of the care is satisfactory . Children respond well to staff whose patient and committed approach helps them to build sound and positive relationships. Interactions were observed to be respectful and caring, with children demonstrating warmth and affection toward their carers.

p.7

Quality of care

There is a minimal approach to seeking the views of children and young people to influence the running of the service, but individual choice is established in relation to food and activities. Various methods of communication are used by the children and staff have sufficient knowledge to maintain a total communication approach.

p.8

Quality of care

Arrangements for dealing with medication are sound and are managed by trained and experienced staff. There is a clear audit trail of medication coming into and out of the service. Some children and young people have complex health care needs and these are understood and well managed by staff. This supports parents and carers in the knowledge that their child is being cared for by competent, medically trained staff.

p.8

Quality of care

Children and young people can take part in a range of activities and the premises has sufficient indoor and outdoor space. The secure garden has good quality toys that promote sensory development and there is a range of resources for arts and craft, music and games. A sensory room provides stimulation with light, sound and texture and in the lounge there is a television and DVD player.

p.8

Quality of care

Case files are in place for each child and although they are personalised the quality of information recorded is variable. A percentage of care plans, individual risk assessments, and behaviour handling plans are not up-to-date and do not fully reflect the care provided. Children are not supported to be involved in the development and review of care plans although, parents, key workers and significant others are. Service managers have started to update case files and this is having a positive impact of the quality of information recorded.

p.8

Quality of care

The home has a complaints procedure that is presented in an accessible format in an attempt to ensure that it can be understood by the children. The home has taken account of and acted upon lessons learnt from complaints.

p.8

Quality of care

Staff observe non-verbal communication and reassure children when they demonstrate distress or upset through a sensitive approach and a good understanding of their needs.

p.8

Quality of care

The property is purpose built, decorated, maintained and furnished to a good standard and has overhead tracking installed and specialist equipment to assist in delivering personal care needs. The passenger lift provides access throughout the building and there is plenty of space for wheelchair users. The dining room provides space for the group to sit around the table where children and young people are appropriately supported at meal times.

p.8

Safeguarding children and young people

The service is satisfactory at keeping children and young people safe and feeling safe.

p.9

Safeguarding children and young people

Children and young people are cared for in a physically safe environment. Parents state that they feel that their child's safety is given a high priority. Staff recognise particular vulnerabilities related to diverse needs of children with disabilities and take steps to address these. Care is provided in a respectful way and staff are sensitive to children’s privacy and dignity. However some children who have epilepsy are monitored overnight by the use of listening devices in addition to care from waking night staff. Care plans do not detail that the need for listening devices has been assessed and consented to, and there is no formal policy in place to guide staff on the appropriate use and management of such devices and how they promote the welfare of children.

p.9

Safeguarding children and young people

Children’s safety is promoted by the use of individual and activity risk assessments which identify known and likely risks and how these can be reduced. These are not always updated on a regular basis and signed by the manager and parents as agreed. The home is appropriately secure to take into account the needs of the children. Detailed fire risk assessments, equipment safety checks and regular health and safety audits are undertaken to promote safety and well being.

p.9

Safeguarding children and young people

Good staffing ratios provide a level of supervision where incidents of any children going missing, or incidents of bullying are negated.

p.9

Safeguarding children and young people

Staff receive regular training in safeguarding. All staff spoken to are aware that allegations or suspicions of abuse must be reported to senior managers and external agencies. The service manager is the designated person responsible for handling safeguarding concerns within the organisation and demonstrates a good level of competency.

p.9

Safeguarding children and young people

Children enjoy sound relationships and interact positively with staff and others. The service promotes a positive culture of managing behaviour; sanctions are not used and there is a focus on encouragement, praise, and de-escalation. Staff receive regular training in an approved method of physical intervention and it is only used to keep children safe from harm. The service continues to work with local authorities and families to ensure any use of handling belts is risk assessed and fully documented. This piece of work is not yet completed and in addition, the behaviour policy does not clearly reflect what strategies and equipment may be used.

p.9

Safeguarding children and young people

There are clear systems in place to recruit new staff and they do not start work until appropriate checks have been carried out. Telephone enquiries are made when it is identified that there is a potential concern on a reference, however this is not standard practice for verifying all written references. A full employment history is required but application forms do not evidence written explanations of gaps in employment.

p.9

Leadership and management

The leadership and management of the children's home are satisfactory .

p.10

Leadership and management

The home is managed by a suitably qualified and experienced manager who has the support and respect of the staff team. Managers and team leaders keep up-to-date with new information and legislation.

p.10

Leadership and management

The provider meets the aims and objectives as detailed in the Statement of Purpose. This document is clear and accessible but does not describe how the service consults with children or how the service supports children’s behaviour and education.

p.10

Leadership and management

Staff feel supported by senior staff and benefit from daily handovers and the opportunity to attend regular team meetings. Annual appraisals are carried out in order to review staff’s performance; however formal supervision is not undertaken to the level determined within the service’s policy. The service provides a detailed induction programme which requires new staff to work shadow shifts and to complete a knowledge and skills booklet, thus evidencing their level of understanding of the service and how to support the children. Mandatory training is delivered and regularly updated. Staff report that health intervention training is sufficient to equip them with the skills to support children with complex health needs, however feel less confident in supporting children with autism and who experience bereavement and loss.

p.10

Leadership and management

Staffing levels offer one-to-one care enabling children to have a personalised support package. In addition there is a dedicated core team of staff who work specifically with the children who live at the home permanently ensuring there is a consistency of approach and care giving. Staff work well together and there is a good team spirit which impacts positively on children. Managers work in conjunction with other professionals and seek the views of others concerned with the care of children placed.

p.10

Leadership and management

The home is regularly monitored to ensure compliance with regulations; however, visits do not consistently involve seeking the views of the children or observe the care provided. A deputy has been appointed to assist the service manager to establish and maintain an effective quality assurance system and written development plan. This work remains very much in its infancy and consequently means that there is no clear identification of the service’s strengths and weaknesses and progress towards objectives is not explicit.

p.10

Leadership and management

The service manager has been proactive is acting upon the requirements and recommendations from the previous inspection; however, not all issues raised have been fully met. The action that has been made towards resolving the use of handling belts and producing a system to support children to communicate concerns has had a positive impact.

p.10

Leadership and management

Equality and diversity practice is good .

p.10