Children's Home run by Somerset County Council in Somerset

Unique reference number SC030439 Inspection date 17/08/2011 Inspector Paula Lahey Type of inspection Full Provision subtype Children's home

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Date of last inspection 10/11/2010 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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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

The home is registered to provide a service for up to eight children and young people of both sexes with emotional and/or behavioural difficulties, from the age of 13 years up to the age of 18 years.

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Brief description of the service

This local authority children's home can provide children and young people who have complex learning disabilities and associated communication and behavioural needs with both permanent residency and short break stays.

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Overall effectiveness

The overall effectiveness is judged to be good .

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Overall effectiveness

One of the strengths of this home lie in the stability, commitment and experience of the staff team coupled with the strong leadership and support from team leaders and managers. As a result, young people using this service have individualised packages of care and experience positive outcomes. Primarily the service ensures that young people enjoy their time in the home, maximise on the opportunities for new experiences and learn more appropriate ways to manage their behaviour. The environment is one that nurtures, supports and encourages young people as individuals. Staff have extremely good knowledge of the individual needs and characteristics of young people and promote assurance, confidence and improved ability.

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Overall effectiveness

There are good relationships with education and young people's individual attendance and achievement is supported well. Young people's general health is promoted and it is evident that developing emotional and physical well-being is paramount. This inspection makes one requirement relating to ensuring that restraint records contain all required information and recommendations have been made to clarify and enhance some of the national minimum standards or procedures.

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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

17B (2001) ensure that a written record is made of the use of any measure of control, restraint or discipline which shall include: the details of any methods used to avoid the need to use that measure. 01/10/2011 (Regulation 17B (4) (b))

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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 staff are kept up to date with professional, legal and practice developments. This relates specifically to competency assessments of medication practices (NMS 18)  ensure staff are equipped with the skills required to meet the needs of the children. This relates specifically to theoretical behavioural training (NMS 18.1)  ensure that children are able to participate as fully as possible in planning their care (Volume 5, statutory guidance, paragraph 1.15)  create a written development plan for the home. (NMS 15.2)

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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

The home provides a nurturing environment where young people who live in the home permanently and those who access short breaks are supported to achieve their full potential. There is a cohesive multi-agency approach to assessing and addressing individual needs. Consequently young people receive personalised and consistent care resulting in positive outcomes for their physical and emotional well-being. Young people enjoy excellent health and the team monitor welfare, physical condition and behavioural patterns closely in order to provide clear evidence of current needs and presenting behaviours to consultants and families. The staff team are clearly experienced and successful in working with young people who have severe learning disabilities and complex communication and behavioural needs.

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Outcomes for children and young people

Young people have a tailor made transition to the home, which includes visiting the service to meet staff and joining in with activities before building up to an overnight stay; this helps to develop young people’s confidence and trust in the staff. Young people are also helped by staff through their transition to adult services. Key workers will visit provisions with them, advocate on their behalf in meetings with adult service providers and make sure young people are settled into new services. These well- planned arrangements mean that young people are prepared emotionally and practically to their transition either into the home or onto the next stage in their lives.

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Outcomes for children and young people

Young people enjoy good healthy meals while in the home and are actively involved in the creation of menus. There is good recognition of their individual dietary needs and personal preferences; these are incorporated into daily menus alongside a wide range of foods to enable young people to experience new tastes. Subsequently young people who previously chose a limited diet have been trying new foods and determining genuine likes and dislikes. Mealtimes are fully inclusive social occasions where young people were observed to enjoy the experience of eating together and learning skills for independence.

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Outcomes for children and young people

Young people receive full-time education and the home works in partnership with education providers to ensure that young people’s individual needs and targets are consistently managed. Through observations of young people in school and active participation at education reviews staff have a good understanding of young people’s learning needs. This proactive approach to educational achievement ensures children are provided with support and guidance to reach their individual goals. Comments from parents include: ‘A good thing about Beechtrees is the excellent communication between home, school and Beechtrees. All parties are working well together to give my child the independence skills he needs for later life’.

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Outcomes for children and young people

Young people have access to a range of activities within the home, including a sensory room, extensive garden area and a computer room. Young people use the garden area to run and play or use the trampoline and other outside play equipment. Activities in the local community are promoted and designed to develop social interaction, independence skills and increase self-esteem. Recently young people enjoyed an adventure activity holiday where they were able to participate in climbing, archery and shooting. Some young people become anxious with changes in their routine and trying new experiences. However, the staff team manage this well in order to sensitively and carefully challenge young people and enable them to take age appropriate risks. It is evident that young people feel confident and secure with the staff and this enables them to try new experiences and increases their self- esteem.

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Outcomes for children and young people

The service works in partnership with families and significant others to ensure that young people maintain positive relationships. Placing social workers report this as a strength of the service and have been impressed with the sensitive way in which potentially difficult contacts have been facilitated.

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Outcomes for children and young people

Without exception the staff have high aspirations for young people who all have goals to help develop self-care, independence skills, self-esteem, communication and making choices. Regardless of their starting point all young people have made progress in this environment.

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Outcomes for children and young people

Placing authorities report significant improvements in young people’s challenging behaviours and feel this is down to the staff team maintaining a calm approach and providing clear boundaries and routines. This in turn enables young people to feel secure and safe and more effectively manage their anxieties. Families and social workers are delighted with the progress that young people have made and cannot speak more highly of the service.

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Quality of care

The home is a purpose built single story building that provides two core units and two additional self-contained flats. Although young people are supported to come together for activities the living environment provides a more homely and natural atmosphere where young people are appropriately placed to effectively meet their individual needs. The home is located within easy access to all local resources and facilities, and in close proximity to open countryside and coastal regions. The property is decorated, maintained, and furnished to a good standard. Young people have their own bedrooms which are personalised to meet individual tastes and needs.

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Quality of care

A placement plan is obtained from placing authorities in order that there is formal information about how young people's care needs are to be met. Statutory reviews are well attended and plans are regularly reviewed to ensure that they continue to meet the complex and diverse needs of the young people. Although staff work in partnership with families, schools and other agencies to formulate and review care and health plans they have not fully explored how to meaningfully seek the views of young people and incorporate these into care planning arrangements.

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Quality of care

Staff understand young people's individual strengths and needs well. There are consistent working practices which focus on enhancing young people's individual quality of life and potential. Staff are committed to anti-discriminatory practice and to responding to young people so that their individual needs are met and they are afforded equal chances to enjoy normal life experiences. Young people respond positively to staff and interactions were observed to be respectful and caring, with young people demonstrating warmth and affection toward their carers.

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Quality of care

Each young person’s individual behaviour needs are identified and written within care plans. These guide staff to ensure consistent approaches to managing specific vulnerabilities and challenging behaviour. The home is currently devising more comprehensive plans looking at young people’s holistic needs and detailing proactive as well as reactive strategies. Behaviour plans are shared with families and schools to reinforce positive changes in all areas of the young people’s lives.

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Quality of care

Through team meetings staff have valued the opportunity to share practice issues and evaluate the effectiveness of behaviour strategies used with young people who have since left the home. This has resulted in staff feeling more confident to try different strategies with current residents. Although staff are provided with behaviour management training for de-escalation and restraint there is limited focus on understanding behaviour and the functions of behaviour. This means that the staff team may not fully understand the theoretical basis of why young people behave in challenging ways.

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Quality of care

Medication is administered in a person centred way and with consent. Staff receive training in the safe administration of medication and access specialist health training in order to support individual young people’s needs. This has included diabetes, epilepsy and administration of emergency rescue medication. Current medication systems are well managed and provide safe care and support for young people, however, staff have not received regular checks of their competency to ensure ongoing good practice is maintained.

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Quality of care

Staff are skilled at interacting with young people using appropriate verbal skills and alternative methods of communication. There is effective use of signs, symbols and objects of reference. This ensures young people can make choices during their stays, for example, in relation to food, snacks, drinks and activities. Staff observe non- verbal communication and reassure young people when they demonstrate distress or upset. Staff ensure that they are sensitive in their approach and have a good understanding of the young people’s needs. Staff seek young people’s views about living in the home through observations and reactions to situations alongside more formal processes such as house meetings and using signs and symbols. Action plans are formulated in response to suggestions made by young people and have resulted in increased activities to local leisure facilities, getting art work framed and displayed

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Quality of care

in the home and moving play equipment to enable increased participation.

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Safeguarding children and young people

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

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Safeguarding children and young people

Placing authorities report confidence in the service for keeping young people safe. Examples include; the staff team effectively supporting young people’s complex and challenging behaviour needs, providing clear boundaries and structure to enable young people’s anxieties to decrease, and keeping families fully informed about young people’s lives.

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Safeguarding children and young people

Staff are vigilant at monitoring young people’s physical and emotional well-being and respond promptly and sensitively to early signs of distress and discomfort. This means young people’s needs are well met and they feel cared for and secure within the home.

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Safeguarding children and young people

Young people enjoy sound relationships with staff and are supported to interact positively with 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. Restrictive handling and restraint is used minimally and only by trained staff within clear boundaries. The team have used breakaway techniques to enable them to effectively withdraw from behaviour incidents. They confirm that restraint is only used as a last resort in order to keep young people and others safe, however, records maintained do not consistently evidence this. Policies are in place to support staff to effectively manage any incidents of bullying or young people missing from the home, however in practice these areas do not present as issues for the young people accessing the service.

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Safeguarding children and young people

Staff receive regular training in safeguarding and this provides them with the skills and knowledge to protect young people from harm and abuse. A number of senior managers have designated responsibility for managing safeguarding concerns and provide a good source of knowledge and support. All staff are aware of reporting their concerns to a senior member of staff in response to an allegation or suspicion of abuse and have been provided with direct links to Local Safeguarding Children Board procedures to ensure staff are able to report issues externally should this be required.

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Safeguarding children and young people

The Registered Manager demonstrates a good understanding of safe recruitment procedures and staff confirm that they did not start working in the home until all required checks had been satisfactorily completed. The identification of visitors is checked before they enter the premises and a visitors book is signed. Staff chaperone guests to the home and check with young people that they are happy and settled enough to accept visitors. This good practice empowers young people and gives them the confidence to feel safe within their home and ensures their right to privacy and dignity is respected.

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Safeguarding children and young people

The home is physically safe and appropriately secure to take into account the needs of young people. Detailed risk assessments and fire safety checks are undertaken to promote safety and well-being. Young people are encouraged to develop an understanding of the fire safety procedures; this includes fun activities such as quizzes and games and the provision of evacuation procedures in symbol format.

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Leadership and management

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

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Leadership and management

The home is managed by a competent, confident and experienced manager and team leaders who have the full support of a dedicated and enthusiastic staff team. The needs of children and their families are at the core of the services provided and all attempts are made to meet the diverse range of needs presented and enable young people to make the most of their stay at Beechtrees.

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Leadership and management

Senior staff keep up-to-date with new information and legislation and during team meetings provide opportunities for staff to discuss key issues and evaluate the service to ensure compliance and good practice. A recent example of this has been the staff team reviewing restriction of liberty guidance and looking at the current provision to see how this may impact on the service provided. As a result of this review risk assessments have been completed to determine how young people’s welfare is protected and promoted.

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Leadership and management

The staff team speak positively about the support they receive from each other and their direct managers and it is evident that despite the challenges faced over the past year, staff moral remains high and positively benefits young people. Supervision is provided both formally and informally alongside regularly scheduled team meetings and handover and key worker meetings which enable staff to reflect on their practice and relationships with young people. Annual appraisals are planned over the coming months to provide a more formal review of staff performance.

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Leadership and management

The organisation provides detailed induction training for all new staff and this runs alongside the formal induction standards. New staff report that the induction and shadowing programme enables them to fully understand their role and become familiar with young people’s needs. Team leaders monitor staff training needs and ensure that mandatory updates are carried out and staff are provided with specialist training such as epilepsy, diabetes and total communication training to meet young people’s individual needs.

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Leadership and management

Young people are cared for in line with the home’s current Statement of Purpose. This document has child-focused aims and objectives and clearly details how young people’s educational, health and social needs will be met. The Statement of Purpose is produced in a pictorial format children’s guide in an attempt to ensure that young people can understand the service provided.

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Leadership and management

There are records of regular visits under Regulation 33 of the Children’s Homes Regulations 2001 and there is evidence that children are observed and consulted during these visits. The Registered Manager undertakes Regulation 34 checks on a monthly basis and works in partnership with team leaders to analyse information to determine any patterns or trends. Managers demonstrate a good understanding of the home’s strengths and areas for improvement, although this has yet to be formalised into a clear development plan.

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Leadership and management

Staffing levels are of a sufficient number and young people who are assessed as needing two to one support have this provided for. Agency staff are used to support night care staffing levels and work alongside contracted employees to ensure continuity of care for young people. Families and placing authorities report that a strength of the organisation is that the staff team provides stability and a consistent approach to the young people.

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Leadership and management

Young people’s records are clear and stored securely. Records are up to date and effectively contribute to an understanding of the child’s life.

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Leadership and management

The rapport between staff, managers and young people is warm, friendly and respectful. Manager's have the welfare of young people and staff at heart and encourage them each to achieve well. Staff are enthusiastic about their care of young people and in their commitment to ensure positive outcomes for them.

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Leadership and management

Equality and diversity practice is good .

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