Children's Home run by Liverpool City Council in Liverpool

Unique reference number SC035969 Inspection date 06/10/2011 Inspector Michelle Moss 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 children's home is managed by a local authority providing short-term breaks for boys and girls between the ages of eight and 19 years. The home cares for up to seven children with learning disabilities and physical disabilities at any one time. Many of the children use non-verbal methods of communication.

p.4

Overall effectiveness

The overall effectiveness is judged to be satisfactory .

p.4

Overall effectiveness

Children receive a satisfactory quality of care. The acting manager and staff promote a culture that enables children to build confidence so that they feel safe, protected and valued. This is achieved by the caring atmosphere created by staff.

p.4

Overall effectiveness

Without expectation everyday children are afforded wonderful opportunities to engage in multi-sensory activities that challenge personal growth and development. These opportunities enable children to gain a sense of achievement. There are equally fantastic opportunities to pursue hobbies and interests that reflect children’s age, understanding and abilities. As a result of this child-centred approach, every child is making positive progress in relation to their starting point of receiving short breaks. The level of commitment given by staff means all short breaks are well planned and organised so that children can sustain excellent school attendance.

p.4

Overall effectiveness

There are breaches in regulations that have some impact on the quality of care. For example, there are shortfalls in holding all required information in areas of behaviour management and care planning. Risk assessments for the facilities used by children are not completed to take into account their various needs. The recording of administered medication is not rigorous to ensure records remain concise and auditable. Some parts of the premises are showing signs of wear and tear. There is no formal consent or policy for the use of listening devices. The monitoring undertaken through regulation 33 visits does not extend to consulting with children and other stakeholders. Lastly, the home has not implemented a development plan to help in driving forward continuous improvement. However, despite these shortfalls, the care staff never stop trying to improve outcomes for children. This includes being dedicated in finding imaginative ways to sustain meaningful

p.4

Overall effectiveness

engagement. A common description given by parents about their child’s experience of short breaks is excellent.

p.4

Overall effectiveness

Improvements have been made from the last inspection, with no recurring shortfalls identified. Staff are clearly committed to their work and are trained in safeguarding practices which they deploy skilfully and always in the interest of keeping children safe.

p.4

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) ensure that within 24 hours of the use of any measure of control or restraint, a written record is made which includes all details set out under Regulation 17B (Regulation 17B(3)(g)(h)) 30/11/2011

p.5

Reg. Requirement Due date

12A (2001) ensure the placement plan is kept under review and revised as necessary (Regulation 12A(2)) 30/11/2011

p.5

Reg. Requirement Due date

(2001) ensure there are suitable arrangements for the recording of any medicines received into the children’s home (Regulation 21(1)) 30/11/2011

p.5

Reg. Requirement Due date

(2001) ensure when using monitoring devices for purpose of safeguarding and promoting the welfare of the child concerned, conditions set out under regulation 22 are fully met (Regulation 22(1)(a)(b)(c)(d)) 30/11/2011

p.5

Reg. Requirement Due date

(2001) ensure that all parts of the children’s home used by children are reasonably decorated. (Regulation 31(2)(e)) 31/12/2011

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 where any sanctions or restraints are used, children are encouraged to have their views recorded in the records kept by the home (NMS 3.18)  ensure the child’s placement plan sets out any specific strategies that have been agreed to reduce the incidences of any behaviour exhibited by the child (Volume 5, statutory guidance 2.88)  ensure the specific health responsibilities of the home are set out in the child’s health plan and in the child’s placement plan (Volume 5, statutory guidance 2.46)  ensure where specific measures including electronic devices are used to monitor children, there is a written policy that sets out how they should be used, how they promote the welfare of children, how children will be informed of their use and how legitimate privacy of children will be protected (NMS 10.5)  ensure risk assessments of the whole children’s home environment are carried out, to identify any potential sources of harm to the children and these are

p.5

Recommendations

recorded in writing and regularly reviewed (NMS 10.8)  ensure Regulation 33 visits wherever possible include private interviews with children. Also, consult where appropriate their parents, relatives or carers. Lastly, staff employed at the home must also be interviewed. (Volume 5, statutory guidance 3.13)

p.5

Outcomes for children and young people

Outcomes for children and young people are outstanding .

p.6

Outcomes for children and young people

Children are making progress as a result of their short breaks. This is made possible by the fantastic opportunities they are given to develop personal and social skills through well coordinated nightly activities and dedicated care they receive from care staff. This enables every child to participate in a full range of activities in the home and by accessing the wider community. This commitment by the home ensures every child has a full range of opportunities which enhance children’s enjoyment and maximise their potential.

p.6

Outcomes for children and young people

The home’s strong links with parents, schools and the place authority means children sustain excellent school attendance. The home is central to schools attended by children and this means they can participate in extended day activities operated by their school and still enjoy activities at the home. Children make positive remarks about their stays including it being lots of fun and always lots of activities.

p.6

Outcomes for children and young people

Children are supported by staff who make sure links are maintained with their families, school and health professionals so that changes in needs are known. The staff work tirelessly to ensure they get to know the different methods of communication used by children and use their skills of augmented communication to ensure children are consulted and are able to make informed decisions. The wonderful rapport between staff and children make the atmosphere relaxing for children, whilst equally helping children feel safe. Parents report being confident in the staffs’ abilities and know their children are happy and more importantly safe, when at the home.

p.6

Outcomes for children and young people

The care staff recognise the importance of person-centred care, empowerment and equality. Great care is made to ensure children are provided with a homely and supportive environment in which they can stretch their imagination through sensory engagement, or from being able to relax in comfort with friends. The level of usage of these facilities by children validates they are benefiting from opportunities provided.

p.6

Outcomes for children and young people

The care staff play an active role in helping children flourish in readiness for their transition to adulthood. This often means making a strong commitment to attending meetings and contributing to assessments; so that children can have a smooth transition.

p.6

Outcomes for children and young people

Children have inclusive access to health services in the wider community to meet their physical and emotional needs. There are excellent links with the local children’s hospital for those children with complex health needs. This ensures that children sustain good health whilst staying for short breaks.

p.6

Outcomes for children and young people

Children’s backgrounds are thoroughly respected by care staff. This extends to children being able to sustain practices that enhance their heritage and identity. This includes optimising meaningful contact with families and friends important to them.

p.7

Outcomes for children and young people

Irrespective of disability, ethnicity, faith, gender or beliefs, children are accomplishing significant personal milestones that are preparing them for adulthood.

p.7

Quality of care

The quality of the care is satisfactory .

p.7

Quality of care

Staff interact well with the children and help them make informed decisions wherever possible. There is not a single day where children cannot experience a fulfilling range of activities. These can be from accessing facilities within the home including the sensory light room and soft play area, to going out and accessing the wider community.

p.7

Quality of care

Designated health practitioners visit the home on a regular basis providing staff with advice and guidance. There is a clear system to ensure medication is safely received and stored to meet the well-being of children. However, some of the recording out of medication administered is not concise. This makes auditing difficult. For example, records sometimes hold incorrect times when medication was administered. This compromises having an accurate log to validate times when children receive their prescribed medication.

p.7

Quality of care

The care staff implement positive behaviour strategies to support children to manage their emotions reflective of their learning difficulties. This includes having a resourceful range of redirection and de-escalation techniques that help children feel safe and secure. However, sometimes children place themselves at immediate danger and staff need to use more physical intervention strategies to minimise the risk of harm. These physical intervention strategies have not been fully assessed to ensure the level of direct contact with children does not place any additional risks to the child or the staff. Also, this required level of intervention is not formally captured in the placement plan.

p.7

Quality of care

There are no recorded complaints raised by children. A leaflet is available to children which informs them about raising a complaint. There is excellent engagement with an advocacy service which enables children to discuss concerns with someone independent of the home. The visitors attend frequently, so that children can have concerns quickly dealt with.

p.7

Quality of care

There is detailed guidance for appropriate use of information technology, such as email, digital cameras and the internet, to make sure children are not put in danger of abuse or exploitation. However, as part of monitoring children’s well-being, listening devices are used. These are not supported by a written policy that sets out how they should be used, how they promote the welfare of children and how children will be informed about their use. Furthermore, consent from parents and the placing authority is not formally secured. This shortfall in gaining consent and forming a policy means the home are not demonstrating how they are balancing the privacy and welfare of children.

p.7

Quality of care

Care staff are knowledgeable about children’s cultures and ensure areas such a dietary needs are fully met. There is excellent consultation with parents to ensure religious preferences are both understood by staff and respected in the direct care of children.

p.8

Quality of care

Children are afforded spacious accommodation. This has been enhanced by an extension which has increased children’s choice over where they wish to relax or play. However, some of the bedrooms are showing signs of wear and tear, which is impacting on the quality of comfort.

p.8

Quality of care

Of the parents surveyed, overall they hold the home in high regard. Their comments include acknowledging the home is helping to give them respite so they can relax knowing their child is well looked after and having fun. Professionals involved in the service also view the home positively. This includes finding staff to be very caring and child-centred in their practices.

p.8

Safeguarding children and young people

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

p.8

Safeguarding children and young people

All care staff are confident in areas of child protection issues and have the necessary knowledge and skills to keep children safe. Strong links with other agencies gives staff access to up-to-date advice and guidance, so that everyday practices put children’s welfare first. Through working together with parents, social workers and other agencies, the staff help children to stay healthy and to feel safe. Practices that enhance dignity and respect are well embedded in practice. All care staff receive regular safeguarding training. Safeguarding is steered by the leadership to ensure the quality of provision is always maintained in the best interests of children. This includes children being protected from hazards associated with fire, water, electrical safety and also from going missing.

p.8

Safeguarding children and young people

The care staff fully appreciate the vulnerability of children and the serious implications bullying can have on their welfare. There is a commitment by care staff to be vigilant to any signs of potential bullying. Children surveyed both report feeling safe and also free from being bullied.

p.8

Safeguarding children and young people

Written guidance on safer recruitment practice is in place to ensure the recruitment and selection process of new staff remains meticulous. In addition, regular repeats of Criminal Records Bureau checks are completed to ensure staff continue to be suitable to work with children.

p.8

Safeguarding children and young people

A hierarchy of behavioural techniques are used, which take into account the child’s age, understanding and the seriousness of the situation at any given point. This support helps children to cope with their emotions. Where care staff need to give additional help, they use diversion, re-direction and de-escalation. However, physical intervention logs do not always report on these initial techniques. The home does hold the required bound log book, although its level of detail is missing some essential information and is not always page numbered. Despite these shortfalls, additional incident logs are completed where the missing information can be found. However, these logs are not securely bound. More positively, care staff demonstrate in their care of children that they are very sensitive to individual needs and respond immediately if a child is showing any sign of becoming distressed and intervene before it escalates.

p.8

Safeguarding children and young people

Within children’s care plans are risk assessments for areas such as moving and handling. However, there are no risk assessments for the whole home environment used by children that help the staff to identify any potential sources of harm. For example, there are no risk assessments completed on the use of the soft play area.

p.9

Leadership and management

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

p.9

Leadership and management

The care staff undertake their responsibilities of care very seriously. This includes ensuring children are treated with dignity, respect, sensitivity and fairness. There is a strong commitment towards meeting the disability, gender and individual needs of the children, which is visible by the interaction between children and staff.

p.9

Leadership and management

There are reports which demonstrate that regular Regulation 33 visits take place. However, these reports hold limited evidence to show that consultation with children is common place. Furthermore, there is an absence of other stakeholders being consulted such as staff and parents. More positively, monitoring of records is undertaken by the manager and helps to identify some of the strengths and weaknesses within the service. Nevertheless, this does not extend to having a development plan for recording future improvements.

p.9

Leadership and management

Children’s records provide a good picture of each child’s life, including their likes and dislikes. Professionals involved with the home remark that the staff work hard to involve the children in their care planning. However, some of these records are not being kept up to date to reflect changes in children’s needs, especially their medical needs. In some cases, care plans are over one year old. Key instructions on changes in medical intervention are not always recorded directly to the health plan and instead found on loose paper with no validation where the information was received from and when these new instructions on care were to be implemented. There is also no adjustment made to the care plan. This results in having two conflicting pieces of information on how care should be delivered.

p.9

Leadership and management

Joint working is common place. Multi-agency partnerships are forged with health and schools. By working together the best interests of the children are central to decisions. This is best evidenced in the co-ordinated work being undertaken to help children through the transitional stages to adult care. Children are supported by sufficient numbers of skilled staff to meet their needs. Staff receive regular supervision in which their performance is closely monitored. Staff training is also given a priority to ensure all staff hold the required qualifications and knowledge necessary to support children with disabilities and particular medical needs.

p.9

Leadership and management

The trust between children and staff is evident within their everyday interaction. There is a wonderful rapport that enables children to experience rewarding short breaks. There is a clear, accessible and comprehensive Statement of Purpose that clearly sets out its aims and objectives of the home. These objectives are being utilised in everyday practice, including ensuring children stay safe, feel safe and are well cared for during their short breaks.

p.10

Leadership and management

The one requirement from the last inspection has been addressed. This has resulted in an increase in the number of fire drills completed. This enhancement means staff and children are increasingly familiar on how to safely leave the building in the event of a fire.

p.10

Leadership and management

Equality and diversity practice is good .

p.10