Children's Home run by Nottinghamshire County Council in Nottinghamshire

Unique reference number SC036726 Inspection date 26/07/2011 Inspector Rosemary Chapman Type of inspection Full Provision subtype Children's home

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Date of last inspection 03/03/2011 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 home is operated by the local authority. It provides a residential service for eight young people, aged seven to 18 years, and a short-break service for four young people, aged four to 18 years. The home additionally has an emergency bed on the short-breaks unit. All the young people have severe learning disabilities and challenging behaviours.

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Overall effectiveness

The overall effectiveness is judged to be outstanding .

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Overall effectiveness

Young people make exceptional progress at this home, due to an outstanding quality of care, committed, well trained and supported staff and excellent management. A young person said: 'I like coming here, I like going out and I feel very nice and safe.' The major strengths include an enormous commitment to ensure young people can communicate their views, wishes and feelings effectively, rigorous care planning and an emphasis on continual evaluation and development. Care practice is highly individualised, innovative and regularly evaluated to ensure it is effective. The management team are systematic and rigorous in ensuring staff develop a consistent service of a high quality. Excellent quality assurance and monitoring mechanisms, combined with very regular feedback from young people, parents and other professionals inform all future developments of the service and there is no sense of complacency.

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Overall effectiveness

Communication with parents, carers and stakeholders is of an excellent standard. This ensures everyone is kept informed, works consistently together and contributes their opinions about how the service is operating. To quote a parent: 'They are brilliant. They come to every review and never let us down.' The only minor shortfall identified is that the children's guide does not contain the details of Ofsted's address and telephone number, but this has minimal impact on young people's well-being.

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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 person(s) must comply with the given timescales.

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Reg. Requirement Due date

4 ensure the children's guide contains the address and telephone 31/08/2011 (2001) number of HMCI. (Regulation 4(3)(c))

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Outcomes for children and young people

Outcomes for children and young people are outstanding . Young people make exceptional progress in all areas of their life. They are all seen as individuals and responded to as such, which increases their positive self-view. Young people participate in a wide range of activities of their own choosing, such as bowling, the cinema and horse riding, and have full access to the community. They are never seen as being unable to participate because of their disability, and when facilities have been reluctant for the young people to attend, this has been rigorously challenged. This participation enables young people to develop their social skills through positive interaction with their peers and other people.

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Outcomes for children and young people

Young people have made significant progress in relation to health needs. For example, young people have increased the range of food they eat, which results in a healthier diet. They have also improved in the way they eat, for example, using cutlery or sitting at the table, which is beneficial in terms of social interaction. Young people have also lost weight and developed healthier lifestyles, where this has been an issue. To quote a social worker: 'Workers have supported a young person and significantly improved the quality of life; the young person has lost weight, is generally a lot healthier, and has the clear and consistent boundaries that have helped develop independence and care skills.' Another stakeholder commented that the staff were able to challenge health professionals when they had concerns about a young person's health and sallow appearance, and that person now looks very well. Issues of self-harming have also decreased significantly. A social worker said: 'The

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Outcomes for children and young people

work done with a young person has meant that the self-harming behaviour has diminished.'

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Outcomes for children and young people

Young people have also made significant progress in terms of communication skills. A parent commented: 'Staff have worked on communication and I have seen a real improvement', and a social worker commented, 'the capacity to communicate has extended beyond what I would have thought possible.' Another parent commented about seeing a real improvement in her child's social skills, an improved quality of life and improved language skills.

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Outcomes for children and young people

Young people have very good school attendance while at the home, either during their short break or while in full-time residence. They attend their usual school if they are accessing short breaks, or are in an educational placement if they are residential. Staff ensure young people reach their full potential by excellent communication and liaison, and attending every review, where they make a full contribution, to promote consistency and information sharing.

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Outcomes for children and young people

Young people have very good contact with their family and people who are important to them. This particularly relates to the young people in the residential side, but young people having a short break can also speak to their parents on the telephone should they wish to do so. A social worker commented on how well staff support a young person with contact. Staff provide discreet supervision and enable the young person to be independent, for example, by making the visitors a cup of tea. This really enhances the young person's self-confidence, self-esteem and enjoyment. The family have also commented on how welcome they are made to feel.

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Outcomes for children and young people

Young people are extremely well prepared to make the transition to adult services. Staff plan these meticulously on an individual basis, for example, by preparing a book of photographs of the new resource for the young person to see. Transitions are facilitated by excellent communication with the relevant services, a commitment to attending leaving care reviews and supporting the young person in visits to help them settle. They are also very well supported to become as independent as possible while at the home. They each have an independence plan, which staff implement and evaluate. This ensures they make as much progress as possible.

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Quality of care

The quality of the care is outstanding . Staff at the home provide an outstanding quality of care which enables young people to achieve very positive outcomes. Extremely informative and detailed residential action plans, coupled with risk assessments and behaviour management plans, ensure that all staff know exactly how to support young people in a consistent way. Staff are in the process of developing sophisticated sensory plans for the young people who benefit from this type of support. This is one of the ways in which negative behaviour is prevented. For example, there is a heavy blanket on one of the settees which young people can use, or a vibrating foot spa, spinning office chair, and so forth. Sensory sessions are planned into young people's days, so they are not used reactively, but as a way of proactively managing behaviour. In this way, young people are enabled to enjoy positive and constructive relationships with staff and

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Quality of care

A major strength of the home is its commitment to obtaining the views of young people and acting on their wishes and feelings as much as possible. Communication is an area which has really developed. Each young person has a communication plan, communication box and ready access to their preferred means of communication. Signs and symbols are available throughout the home and staff are trained in a variety of communication methods. Key workers have regular sessions with young people to consult them, and produce books which reflect their wishes and feelings on an ongoing basis; these are then presented to their reviews. A social worker commented: 'I have always been so impressed by how child-centred the workers are there; they always consider the child's needs, wishes and feelings in all aspects of their daily work. I am particularly impressed with how the key worker works with this young person to gather wishes and feelings for reviews and is creative in how this is

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Quality of care

done.' Developing a ball pool is one example of where young people have influenced the running of the home.

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Quality of care

Young people have access to an independent advocacy service. The worker visits regularly to meet with young people. Contact details of the advocacy service, as well as the complaints procedure are clearly advertised on the notice board in an appropriate format. This enables young people to express any concerns they may have, independently of their key worker and other staff.

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Quality of care

Young people's needs are assessed in a very individual way, including those relating to culture and religion. The placement plan is accessible on the electronic system but the residential action plans form the home's working documents which they use on a day-to-day basis. These are also accessible on the electronic system, so social workers and independent reviewing officers can access them also. Residential action plans have been another area of development to make them more person-centred. There is now one page which tells someone all they need to know in a person- centred way. This is then followed up in detail with information about communication, decision making, education, health, safeguarding, promoting independence, social stories, routines triggers, interaction and play techniques, and support needs. A stakeholder commented: 'The residential action plan has an outstanding amount of information.' These plans are implemented fully, which again

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Quality of care

is endorsed by the positive comments received from parents and stakeholders, and the positive outcomes. Regular case management meetings monitor and evaluate the plans to ensure they continue to be effective and relevant.

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Quality of care

Health needs are fully assessed and addressed, resulting in some excellent outcomes as highlighted above. A variety of support services are accessed as appropriate, for example, occupational therapy. Medication routines are robust and staff fully trained to ensure safe practice. Staff are also trained so that they are able to manage more complex heath needs such as epilepsy. Meals are varied and healthy and take into account young people's preferences as well as health and cultural issues. For example, the cook prepares gluten-free pastry products for those with gluten intolerance, as well as food from a range of cultures.

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Quality of care

The location of the home is very suitable for the young people's needs. It is in a rural location but with very easy access to a small town, with shops, a leisure centre and cafés. The home itself is well designed with lots of communal areas of varying sizes, which offer a range of activities, such as arts and crafts, music, television, and sensory rooms. Bathrooms and toilets are fully accessible and adapted to meet the needs of the young people. Young people on the residential side have their own facilities and all bedrooms are personalised; young people choose their animal- themed room when accessing short breaks. The garden provides a range of facilities including a small pool, secret area, trampoline and music shack. It is secure so young people are safe.

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Safeguarding children and young people

The service is outstanding at keeping children and young people safe and feeling safe. Extremely well-developed staff practices, which are underpinned and supported by comprehensive policies and procedures, ensure that young people's safety and well- being are promoted to an outstanding level. Staff understand how to protect young people because they are regularly trained in safeguarding procedures and understand how to implement them. Responses to potential harm are developed to a very high level and managers demonstrate very proactive practices. Although some of the young people have regular marks on their bodies due to behavioural issues, the staff are keen not to make assumptions about the cause. Thus any unexplained mark is thoroughly assessed, even though it could be attributable to usual patterns of behaviour, and referred to the young person's social worker, thereby ensuring all possibilities are thoroughly explored and young people are protected from harm. The

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Safeguarding children and young people

Local Authority Designated Officer is involved appropriately and staff give their input to strategy meetings.

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Safeguarding children and young people

Young people do not go missing from the home because there is a high level of security for the premises and very high staffing levels. There are protocols with the police should this happen, and all situations are thoroughly risk assessed, particularly when young people are in the community. Risk assessments also protect young people from being bullied, as any possible situations are assessed and minimised. Bullying is not an issue in this home.

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Safeguarding children and young people

Many young people exhibit challenging behaviour to varying degrees. Extremely thorough residential action plans and risk assessments address this very effectively, and a variety of innovative strategies are used. These include a high emphasis on sensory methods, and intensive interaction. Staff are fully aware of the appropriate response to individual young people based on these documents, thus ensuring responses are consistent and effective. There is evidence of very regular review and update. Promoting independence is also part of the action plan, so young people can take reasonable risks as appropriate to age and vulnerability. Young people are encouraged to achieve rewards for positive behaviour and this is made very clear. For example, young people can work towards a special activity by achieving particular behaviours. Restraint is used appropriately and only by staff who are trained in a recognised method, when used, it is well documented, and reviewed by

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Safeguarding children and young people

the manager to ensure the practice is sound. Likewise sanctions are used appropriately, documented and reviewed.

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Safeguarding children and young people

Staff, including agency workers, are recruited by robust measures to ensure they are not unsuitable to work with children. Agency staff have an induction to the practices of the home so they are aware of the specific issues related to caring for the young people who live at the home.

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Safeguarding children and young people

Young people live in an environment which is physically safe and secure, so they are protected from physical harm. Risks are thoroughly and comprehensively assessed and minimised, and maintenance checks are regularly carried out. Young people are made aware of fire procedures in a way that addresses their level of understanding. For example, some young people have a symbolic social story about this so they know what to do and do not worry unnecessarily.

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Leadership and management

The leadership and management of the children's home are outstanding . The home is extremely well managed and provides a very effective service to the young people. Although there were no requirements or actions made following the last inspection, the home has continued to develop and improve. There is an impressive range of quality assurance and monitoring mechanisms, over and above those which are statutorily required. Very regular feedback from social workers, schools, parents and young people, combined with up-to-date research, informs the home's development plan. This in turn leads to a training plan for staff so they can deliver innovative and effective services. Examples of improvements in the last few months include more person-centred residential action plans, the development of sensory plans, improved communication systems and tighter safeguarding mechanisms. All these improvements have resulted in significantly improved

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Leadership and management

There is excellent communication at all levels. Managers meet weekly, and the outcomes of this meeting feed into the fortnightly staff meetings. These provide a useful forum for sharing information, training, presentations and discussions about children, all of which foster a strong team spirit and aid consistency. Staff are encouraged to contribute their views about how the home should develop, and it is very evident that staff respond to this with enthusiasm and commitment. Each member of staff has a specific responsibility, for example, medication, sensory plans or communication. This is an effective tool as it not only ensures tasks are undertaken because they are clearly allocated to someone to do, but also the responsibility empowers staff and enhances their own sense of achievement, professionalism and self-esteem.

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Leadership and management

The Statement of Purpose, the information booklet for parents and the children's guide give relevant information to staff, stakeholders and service users about the service they can expect from the home. The children's guide is in a very appropriate format but it does not contain the address and telephone number of Ofsted, as required by regulation, although it does have the logo. This shortfall has minimal impact on the young people who use the service.

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Leadership and management

The staffing levels at the home are appropriate for the needs of the children, some of whom require two members of staff to support them at times. The staff team is mixed in terms of age, culture, experience and gender, so young people have some choice in who supports them. Young people also benefit from the different experiences that staff offer. Staff are very competent to meet the needs of the young people. They are supported by regular and effective supervision, accessible and approachable managers and access to an impressive range of relevant training. The effectiveness of this is endorsed by comments made by parents, social workers and independent reviewing officers. One social worker commented: 'My overwhelming assessment for the children and young people placed at this home is that their life chances are improved by accessing expertise and commitment from a conscientious staff team.' A parent commented that staff, 'are very motivated to help my child

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Leadership and management

Records are very thorough, timely and up to date. The staff use the same electronic recording system as the fieldwork staff, which enables information to be accessed very quickly by both parties. It also provides a complete record of a young person's time while at the home. Residential action plans and risk assessments are in paper form, for ease of access for staff at the home. These are stored securely.

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Leadership and management

A real strength of the home is its partnership working. It has very positive working relationships with fieldwork staff, health professionals and schools, which benefit the young people as these facilitate consistent care practices. A stakeholder commented: 'Staff work well with social workers, schools and parents; liaison with schools is excellent, they are very well prepared for all reviews and diligently present the young people's views.'

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Leadership and management

Equality and diversity practice is outstanding .

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