Children's Home run by Nottinghamshire County Council in Nottinghamshire

Unique reference number SC036737 Inspection date 04/07/2011 Inspector Caroline Brailsford Type of inspection Full Provision subtype Children's home

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Date of last inspection 28/03/2011 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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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.

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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.

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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

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Brief description of the service

This is a local authority children's home providing residential and short break services for 16 children with physical disabilities and complex health care needs.

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Overall effectiveness

The overall effectiveness is judged to be outstanding .

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Overall effectiveness

Young people all enjoy their time at the home. Their needs are well met because there is a strong and committed leadership team. The manager understands the strengths and weaknesses of the home and is forward thinking and seeks opportunities for improvement.

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Overall effectiveness

The staff are extremely committed and know the needs of the young people exceptionally well. They are totally responsive to their needs and young people show that they really like being with the staff. As a result, young people directly benefit and make excellent progress.

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Overall effectiveness

Staff ratios are high so that good relationships can be developed between young people and staff. This creates a warm, nurturing environment which is extremely positive and stimulating for young people. Young people are treated with the greatest of respect and dignity and their needs are met consistently and sensitively though a highly personalised care planning system.

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Overall effectiveness

Each young person is viewed very positively for their differing personality attributes and needs. Therefore the care delivered is very individual and young people can make good progress in relation to their starting points.

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Overall effectiveness

Safeguarding young people is at the forefront of practice and there are clear systems and practices to protect young people from the risk of harm or abuse. Staffing levels enable young people to take assessed risks while at the same time being protected from the risk of harm and abuse.

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Overall effectiveness

There are some areas for improvement. These include that documentation show that the use of restrictive equipment such as gaiters is only used as a very last resort. Fire drills are regular and up-to-date but have not been carried out monthly in line with the homes own risk assessment. There is no policy for the use of work experience students in the home which has the potential to put young people at risk.

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Recommendations

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

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Recommendations

 ensure that all children and staff have practiced the emergency evacuation plan, this is in relation to the regularity of fire drills set out in the home's the fire risk assessment (NMS 10.9)  ensure that information about children is kept confidential and only shared with those who have a legitimate need to know the information (NMS 22.3)  ensure that restraint is only used in exceptional circumstances to prevent injury to a person, this is in relation to records to demonstrate that gaiters are only used where there is absolutely necessary. (NMS 3.13)

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Outcomes for children and young people

Outcomes for children and young people are outstanding .

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Outcomes for children and young people

Young people receive an extremely good level of care based on their individual assessed needs. This takes into account their age, gender, religion, culture and levels of abilities. There is a particular emphasis on health needs which are very well managed. Young people enjoy good health because staff recognise the importance of and work very closely with parents and other health professionals. Children are as healthy as they can be given their complex needs and all health care tasks are exceptionally well managed so that young people can be comfortable and happy.

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Outcomes for children and young people

Young people's health needs including dietary needs are clearly identified in their care plans and associated records. This helps to ensure their health needs are met in a safe manner. Young people receive highly individualised care in this area and this is confirmed by parents. Where young people do not eat orally, their dietary needs are well met by well trained staff who exercise a high level of dignity and respect. Young people's medical and health needs are further promoted by clear health procedures including the administration of medication which are effectively implemented by staff.

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Outcomes for children and young people

Staff work tenaciously to ensure that individual support is delivered in a way which is extremely relevant to the individual young person and this promotes their individual needs. Staff are exceptionally creative and use every opportunity to give support to young people whatever their needs and abilities. As a result, young people can develop during their placement at this home.

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Outcomes for children and young people

Young people who are due to move onto adult services are well prepared and thought goes in to how young people can prepare to become more independent. Staff ensure that they create opportunities for young people to practice shopping cooking and develop their personal care where this is appropriate.

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Outcomes for children and young people

Contact with parents and other important people is dealt with in a way which is extremely sensitive, this helps relationships to be built on and maintained. Parents report excellent communication from staff at the home which helps to promote the health and wellbeing of young people. Staff work closely with the school and local colleges to ensure young people are able to learn and achieve to their maximum potential.

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Outcomes for children and young people

Young people live in a homely environment. This meets their needs and enables them to develop different skills and thoroughly enjoy and benefit from the facilities of the home. One young person said ‘Caudwell House is a lovely home.’ The home is safe and secure for young people as a result of the effective management of health and safety.

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Quality of care

The quality of the care is outstanding . The young people enjoy extremely well presented accommodation. All areas are decorated and furnished to a very high standard. The home is also clean and well maintained. The facilities in the house are exceptionally well suited to the needs of the young people who regularly use the wide range of specialist equipment. Areas around the house include a teenage room, media room, art room and play room.

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Quality of care

All facilities are well suited to the needs of disabled young people, for example, the media room, which has a large cinema screen and can be enjoyed by all young people, including those who have limited sight. There is also a teenage room which has a touch screen television for young people who cannot use a remote control.

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Quality of care

The gardens are extensive and are fully accessible to all. The garden also provides opportunities for new experiences and learning. For example, there is a sensory garden, decked wooden walk and well equipped garden house for young people to enjoy. Young people's bedrooms reflect their individual likes and personalities.

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Quality of care

Each young person has their own bedroom which enables privacy and dignity to be maintained. Staffing levels and risk assessments ensure young people are able to use and enjoy the facilities in a safe manner.

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Quality of care

The staff are committed to their work and have developed very good relationships with young people. They invest a lot of time in ensuring that they understand each young person's communication method and can therefore be very responsive to their needs. Young people's individual personalities and attributes are well respected and there is a link between communication and behaviour which is seen as part of a young person’s personality.

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Quality of care

Although the home is situated in a quiet location, young people enjoy activities in the community. They access a wide range of enjoyable and meaningful activities according to their individual needs. Staff assist young people to experience activities that they may not usually have the opportunity to experience, for example cinema, bowling and extensive activities in the house.

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Quality of care

All the activities are well planned through the care planning process and staff document the outcomes for the young person. Where a young person has enjoyed an activity, photographs are taken. These photographs represent a very positive image for the young person to keep and use to communicate their enjoyment to their family and at reviews.

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Quality of care

Education has a high profile and staff have very positive relationships with school. Good communication and liaison ensures the comfort and health of young people but also allows them to make progress at school as a result. Staff consistently encourage young people to make progress and have a very individual approach.

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Quality of care

Young people are listened to by staff who regularly establish their wishes views and feelings. Staff are responsive to individual communication when young people are not happy and always try to find the reason why. There are regular questionnaires sent to young people and parents. There is also a wishes and feelings board where if young people are able, they can present a view with the support of the staff. These views are always and consistently responded to and changes made to the running of the home are made as a direct result of listening to young people.

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Quality of care

The care planning documentation is extremely good and therefore ensures that staff are very knowledgeable about the very complex needs of the young people. Care plans are highly personalised and ensure that individual needs and constantly well met.

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Quality of care

There are robust procedures for ensuring that staff are working with the most up-to- date information and the staff can therefore deliver the correct support to the individual. The young people benefit because staff know the information so well and continue to deliver an excellent quality of care.

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Safeguarding children and young people

The service is good at keeping children and young people safe and feeling safe. Safeguarding young people has a high priority. This is because staff know what they must do to protect young people from the risk of harm, while at the same time enabling them to take risks in a safe environment. High staffing levels and a strong knowledge about safety issues for individuals, also ensures the safety and welfare of the young people.

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Safeguarding children and young people

The home has a safeguarding policy, setting out what staff must do if there are concerns of a safeguarding nature. All staff are trained and fully aware of the procedures and are able to recite them, ensuring a good working knowledge. They are very aware of safeguarding information with regard to individuals and work within risk assessments. This ensures that young people are as safe as they can be.

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Safeguarding children and young people

The regular and effective monitoring of records and practices also help to ensure young people receive safe care in line with their individual needs. The staff have all had the opportunity to be trained in the homes fire evacuation policy. The home's fire risk assessment sets out the checks that should take place on fire equipment and the regularity of drills. The checks are all regular and up-to-date, however the drills have not been monthly in line with the homes risk assessment. There have still been five drills in the last year and staff are very clear about how to keep the young people as safe as they can be should the fire alarm be sounded.

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Safeguarding children and young people

The registered manager is clear about what checks are needed when recruiting staff and ensures that all staff are safe to work with the young people. Although records are kept centrally within the company she ensures that she views all documentation herself. She and the staff team are fully aware of the vulnerability of disabled young people in children's homes. All staff have received an Enhanced Criminal Records Bureau check ensuring the safety and welfare of the young people.

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Safeguarding children and young people

Young people enjoy very positive relationships with staff where their achievements, no matter how large or small, are recognised. Behaviours are seen by staff as part of a young person's personality and care planning is used to identify staff responses to such behaviour. There has been no instances of restraint, though the staff have received the relevant training for this.

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Safeguarding children and young people

Where movement is restricted in young people for example with splints and gaiters, it is not always clear in the young person's placement plan or risk assessment that this is a last resort. Staff are confident that there would have to be a risk to health safety or welfare for restraint to be used which ensures that young people are safe.

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Leadership and management

The leadership and management of the children's home are good . The registered manager provides clear leadership and direction to a committed and enthusiastic staff team. She has ensured that robust procedures and systems in the home continue to benefit the young people. For example, the monitoring of care plans and risk assessments. She is fully aware of what is happening in the home both regarding the individual needs of the young people and the operational running of the home. This is because there are a range of systems within the home to monitor the quality of care provided and the running of the home. In addition to these internal systems, Regulation 33 monitoring visits are carried out and reports produced. Young people therefore benefit from a well-managed home where they receive a good level of individualised care.

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Leadership and management

Staff are skilled in meeting the needs of the young people. They are very enthusiastic and enjoy their work. They also know the young people very well so that they receive the appropriate care for their individual needs. The arrangements for ensuring that the changing needs of the young people can be met are good. For example, staff meetings and handovers.

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Leadership and management

Staffing levels are good but not all posts have been recruited to and some staff report that it has been a busy time working at the home since the last inspection. However it is reported that although it has been busy, that at all times staffing levels are very safe. This enables the young people to be protected and make progress.

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Leadership and management

There have been work experience students working recently in the home. There have been times where private information about the young people has been shared through handover where they have been present. There is no policy at this time regarding work experience students which has the potential to put young people at risk of their privacy not being protected. The Registered Manager however takes this issue very seriously and is already actively looking at improvements.

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Leadership and management

Staff receive regular supervision which is supportive to each individual. Regular staff meetings are also an important forum for discussing young people's care and any changes in policies and procedures. Training has a high profile in the home and all staff receive a good induction and mandatory training. This includes safeguarding, first aid, and behaviour management. They can also attend training events which are over and above the standards.

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Leadership and management

Training is always relevant to the needs of the young people and in particular with regard to their complex health care needs. This ensures that young peoples complex needs are consistently well met. Staff demonstrate their learning and competence through an evaluation sheet which helps to identify further learning and evaluates the quality of the training.

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Leadership and management

There is a clear Statement of Purpose which informs young people, their families and placing authorities about the services provided by the home. The Statement of Purpose accurately reflects the practice and registration conditions of this home. The home also has a children's guide which is extremely user-friendly and varies according to the individual needs of the young person. For example there is an audio version for those who are partially sighted. This ensures that young people and their parents know what to expect from the home.

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Leadership and management

Equality and diversity practice is outstanding .

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