Children's Home run by Praxis Care in Leicestershire

Unique reference number SC032069 Inspection date 12/10/2011 Inspector Sharon Treadwell Type of inspection Full Provision subtype Children's home

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Date of last inspection 24/03/2011 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 children's home is operated by an independent provider. The provider organisation is a registered charity and is a major provider of services for adults and children with learning and physical disabilities.

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Brief description of the service

This home provides respite care for 42 young people with learning and physical difficulties, and often complex health care needs, accommodating a maximum of four at any one time. The children and young people are aged between six and 19 years.

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Overall effectiveness

The overall effectiveness is judged to be outstanding .

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Overall effectiveness

The home provides an exceptionally high standard of very individualised care to the young people it accommodates. Young people have clear and comprehensive short break plans and staff work closely with associated professionals, particularly in the local authority disabilities team and health care professionals, and with young people's parents and carers. This provides young people with an holistic service, which promotes the achievement of very positive outcomes in all areas, supports them to develop to their optimum potential and encourages a real enjoyment of life experiences.

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Overall effectiveness

The manager and staff have a demonstrated capacity for ensuring that young people and their families are actively involved in determining how personal care and practical support is delivered. This is combined with a determination that young people will be afforded access to a wide range of activity and personal experiences to enhance their self confidence and extend their functioning capacity. Families view the home as 'friendly, homely, has a lovely atmosphere and absolutely great staff'.

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Overall effectiveness

Currently the monthly independent monitoring visits, conducted on behalf of the provider, do not sufficiently reflect the views of staff, young people and their families or demonstrate how these views have helped the visitor to form an opinion of the standard of care provided in the home. The application form, currently utilised by the provider organisation for staff recruitment, leaves the potential for gaps in employment not to be always identified.

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):  ensure that visits to the home, carried out under Regulation 33, incorporate interviews with young people, their families and staff members to inform an opinion of the standard of care provided (NMS 21.7)  ensure that the application form utilised, for staff recruitment, clarifies the requirement for applicants to identify any gaps in employment history. (NMS 16.5)

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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 are provided with high quality respite care placements. Robust identification of young people's very individual care and support needs, and exceptionally close work with their families, ensures that they enjoy and benefit from time spent at this home. The staff work closely with health care professionals and with the local authority disabilities team, which is responsible for all referrals. This ensures that young people's holistic care and development needs are carefully considered at the point of referral and that there are regular reviews of the home's continuing capacity to meet those needs and to support young people to achieve their full potential. Professional colleagues in the local authority learning disabilities team consider this to be 'a fantastic service, which fully meets the needs of all young people in a very flexible way and which families value very highly.'

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Outcomes for children and young people

The respite nature of placements means that young people's families and carers retain primary decision making responsibility in respect of their health care, education and arrangements for any adult care needed. The staff offer high levels of support to young people and their families to promote positive experiences and outcomes for the young people in all these areas. Staff maintain good contact with young people's schools through visits to observe their interaction in school, regular telephone contact and good use of home/school diaries. This ensures that young people's attendance and achievement in school is solidly promoted whilst they are away from their own homes. Health professionals have regular input at the home in assessing young people's health care needs and in providing specific training and advice to staff on how those needs can best be met. The management and recording of the receipt, administration and disposal of medication is diligent to ensure that

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Outcomes for children and young people

families can be confident that their children's health is prioritised when they stay at the home. Health care professional find that staff are 'welcoming, receptive and ask sensible, appropriate questions to promote the health care of their young people'.

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Outcomes for children and young people

Staff support families in both identifying and accessing appropriate adult placements. Young people and their families often find this a difficult time, particularly since the identification of potential placements, by the local authority transitions team, is often very last minute. A young person due to move on in November is still awaiting allocation of an adult placement. The staff are, however, pro-actively preparing the young person to move on using social stories. All placements are strongly focused on developing young people's functional skills to the very maximum, through the clear identification of very individualised self care and independence skill objectives, according to young people's capabilities.

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Outcomes for children and young people

While young people are placed at the home they are actively encouraged, and very well supported, to participate in a wide range of challenging and enjoyable activities. There is a demonstrated focus on inclusion with staff supporting young people well to access community facilities such as the local library, local pubs for meals out and local shops. Young people benefit from a strongly individualised service, which develops their self care and social skills, increases their confidence, vastly extends their life experiences and strongly supports them to achieve their optimum potential. Families feel 'very happy about the standard of love and care received by my child'. Most importantly young people achieve great enjoyment from their respite stays at the home.

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Quality of care

The quality of the care is outstanding .

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Quality of care

The home accommodates young people with high levels of learning and physical disabilities who often have exceptionally complex health care needs. The promotion of individuality is outstanding within this home. Short break plans are concise but extremely thorough. Plans are written largely in the first person to demonstrate the real consideration given to what the young person would wish to gain from their respite stays at the home. There is robust consideration, which involves young people's families and associated professionals, of how young people's needs will be met in terms of personal care, health care, enjoyment and personal achievement. Young people have been canoeing, abseiling and horse riding, have enjoyed trips on an adapted barge, go to ice skating sessions for the disabled and to specially equipped parks. Within the home they have daily access to an exceptional range of sensory and general play equipment to stimulate and motivate them. Young people

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Quality of care

are generally provided with care packages over many years and get to know the staff exceptionally well. Staff turnover at this home is exceptionally low providing very good consistency of care for young people. Parents comment: 'We feel it is more like our daughter staying with relatives' and 'He is clearly very settled and happy there and feels at home when he arrives making it easier for us to leave him.’

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Quality of care

The home provides extensive support packages, which comprehensively address the individual care, support and development needs of the young people it accommodates and additionally reflect the primacy of their family's involvement in that care. The staff retain close contact with young people's families and carers and encourage them to maintain contact with young people, whilst they are on respite care. The home has a range of successful systems for consulting with families and with associated professionals about standards of care and about the operation of the home. The views obtained are clearly utilised in informing change and development within the home. There is a demonstrated dedication to securing the views of young people. When young people are referred for placement at the home the staff visit their homes and schools to observe how they communicate. Young people have a wide array of communication systems and these are clearly detailed in their care

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Quality of care

plans. Staff utilise these various communication systems extremely well to ensure that young people are supported and encouraged to make positive choices about what they eat, what they wear and what activities they engage in. A staff member commented: ‘In the past, all young people were once expected to learn to use a standard, recognised system of non verbal communication and so were staff. Now we recognise individuality better, we investigate young people's preferred method of communication through families and schools and we make sure all the staff can use it.’

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Quality of care

Where young people are capable of understanding and utilising the complaints procedure they are supported to do so. The procedure is summarised for young people in the children's guide and is readily available to families and associated professionals. There have been no complaints received since the previous inspection. The home has received a number of compliments and thank you cards from families. Often these are sent on behalf of their children to say how much they enjoy their stays at the home, or on their own behalf to express their gratitude for ongoing support services. Comments like 'It's friendly, homely, has a lovely atmosphere and great staff' and 'Workers at the project were quick to develop an understanding of his needs, likes and dislikes, which is not easy as he has no verbal communication and limited understanding' generally sum up the very positive views of young people's families.

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Quality of care

The home provides a warm, welcoming environment for young people, their families, visitors and associated professionals. All areas are exceptionally clean and well presented and the home is spacious and extremely well equipped. The four single bedrooms are occupied by different children when they visit for respite. Each young person's care plan details the preparation required when they are coming to stay and staff make sure that, for example, the correct mattress and pillow are on the bed and that the young person's personal belongings and photos are placed in the room. All bedrooms are fitted with hoists, which are regularly serviced, to ensure that young people can be moved safely. The home's sensory room provides a wonderland for young people, where they can explore a range of tactile objects and sounds and there are story bags, musical instruments and endless games for them to access, with staff support, to support their learning and enjoyment.

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Quality of care

Staff are especially conscious of the vulnerability of the young people they care for. All external doors and gates are properly secured. The garden of the home is readily accessible to all young people, being fitted with ramp access from the house and a range of outdoor equipment is available, including a wheelchair swing and a sensory garden, which young people have helped to plant.

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Safeguarding children and young people

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

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Safeguarding children and young people

Families feel confident that their children are safe when they spend time at the home. Staff are provided with regular training to promote their awareness of their recording and reporting responsibilities should they have any potential child protection concerns. The home has very clear organisational policies and procedures to guide staff practice with regard to prioritising young people's safety. Extremely comprehensive and individualised care planning, and a robust focus on risk assessment, recognises the vulnerability of the young people accommodated at the home and reflects how their safety is highly prioritised during their stay.

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Safeguarding children and young people

Staff feel that that young people do not generally exhibit challenging behaviours. They contend that challenging behaviours largely emerge from young people's frustration at being unable to communicate their feelings or from boredom. Staff feel that their capacity to motivate and engage young people successfully means that young people do not find any need to behave in a challenging manner. Observations of interactions between staff and young people, and placement records, demonstrate this to be the case. There is a high staffing ratio with young people generally receiving one-to-one, individually focused care during their stays at the home. There are no instances of restraint and staff are effective in managing behaviour in a positive manner, using distraction and diffusion if necessary. Sanctions are rarely used because young people's limited capacity to be able to relate any imposed sanction to the behaviour demonstrated would, staff say, make them ineffective.

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Safeguarding children and young people

There are no instances of young people being absent from the home without authority. The home has clear and appropriate policies and procedures, which reflect the high vulnerability of young people due to their learning and physical disabilities, detailing how such situations would be managed, should they occur.

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Safeguarding children and young people

The physical environment is safe and very well equipped to meet the specific needs of the young people accommodated. Families say: 'The physical space at the project is ideal-the rooms are large, spacious and light and there is a multi sensory room with easy to access equipment' and 'The outdoor space is perfect, safe and accessible with lots of room to play and a swing and bouncy castle, which he loves.’ There is diligent professional servicing of gas and electrical installations and of specialist equipment such as hoists and fire safety equipment. This promotes the safety of young people, staff and visitors. An oversight regarding the timely arrangement of the annual required check on gas installations has been recognised by the manager and appropriately addressed.

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Safeguarding children and young people

The provider organisation has sound recruitment policies and procedures and all appropriate checks are demonstrably undertaken to ensure that young people are protected from exposure to unsuitable adults. The way information is requested however, on the current application form, leaves the potential for gaps in employment not to be identified. The information requested does not include the month as well as the year of employment.in respect of the applicant's employment history. The manager confirms that, during the interview process, he fully explores every applicants past employment record. Interview records are stored at the organisation's head office and not at the home and this could not be verified during the inspection.

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Safeguarding children and young people

While there is a robust prioritisation of young people's safety within this home, the staff have a very proportionate approach to risk assessment. This ensures that young people's learning and physical disabilities and health issues do not negate their access to a wide range of exciting, challenging and fulfilling experiences. Staff regularly access activity opportunities for young people through organisations, with specialist expertise, such as the Calvert Trust, which specialise in delivering exciting, challenging and enjoyable outdoor activity adventure holidays for young people with disabilities.

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Leadership and management

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

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Leadership and management

This is an extremely well managed home which offers an exceptional service to young people with learning and physical disabilities and meets the requirements of the Statement of Purpose. The staff are highly motivated and dedicated and are imaginative in their plans to stimulate and care for these young people. The manager offers consistent and extensive monitoring which ensures a very high standard of care is sustained. As a result of this young people feel happy and safe when living at the home and their families are confident that their children’s care needs are fully met.

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Leadership and management

Staff feel well supported in their work and the manager encourages their professional development and consistently expects and receives a high standard from them. Staff are provided with good access to an extensive range of training, often delivered by health care professionals, to enable them to fully understand and cater for young people’s complex health care needs. The level of staff turnover is exceptionally low and this is due, in part, to the atmosphere of enthusiasm, professionalism and motivation shown and encouraged by the manager. One staff member commented that there was 'so much opportunity for staff and children to grow’.

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Leadership and management

The home is very well maintained and resourced and this ensures an excellent provision of varied stimulating activities for the young people. Rooms such as the sensory room and sensory bathroom offer an imaginative resource. Even in the provision of bedroom furniture, such as specific beds for individual children, the home clearly aims to ensure a high level of individualised service. Decoration is of a high standard and the staff consistently re- assess the needs of the home and the young people it accommodates.

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Leadership and management

Staff know all children individually and know, for example, who will have different or personal ways of communicating. Children’s files are clear, with detailed behaviour management plans, risk assessments and means of communication. The files reflect the individuality of care, which the home provides for each young person who stays. Care plans are felt by the manager to be something that ‘the family and child should and can be involved with.’ It is the high motivation of staff and their positive relationships with the young people, which keeps any behaviour issues to a minimum.

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Leadership and management

The manager completes monthly reports to reflect on service delivery within the home and his monitoring is evident in records and extremely thorough. The regular monitoring and plans for development show that there is a commitment to good service delivery and to the continued quality of that service. Monthly visits are made to the home, on behalf of the provider organisation, to independently monitor the standard of service provision and the quality of care. Currently the recording pro- forma for these visits focuses too highly on gathering statistical data. There is insufficient reflection, in the reports, of the views of staff, young people and their families being utilised to enable the independent visitor to form an opinion of the standard of care provided in the home.

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Leadership and management

Equality and diversity practice is outstanding .

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