Children's Home run by Action for Children in Hertfordshire

Unique reference number SC426172 Inspection date 18/10/2011 Inspector Rachel Ruth Britten / Susan Southey Type of inspection Full Provision subtype Children's home

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Date of last inspection 06/04/2011 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

The service is managed by a large charitable organisation. It provides short breaks for up to six children with learning difficulties and/or physical disabilities

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Overall effectiveness

The overall effectiveness is judged to be satisfactory .

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Overall effectiveness

The home successfully provides personalised and well planned care for children. As a result the individual needs of children are adequately met. Overall, children are safe and feel safe in the well equipped, suitable setting

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Overall effectiveness

Feedback from parents, staff and other professionals who form part of the team around the child, is very positive. It indicates that children enjoy coming to the setting and have settled in quickly. Formal, systematic or routine ways of finding out children’s views are not yet well established. Nevertheless, the quality of care provided by the skilled and caring staff promotes positive outcomes and ensures that good quality relationships have been initiated.

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Overall effectiveness

A number of minor individual shortfalls are identified. These pertain to accidents, risk assessments, visitors, complaints, hazard removal, placement planning and medication administration. Shortfalls have also arisen because of the delay in establishing effective manager monitoring systems.

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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

(2001) ensure that placement plans are completed, agreed and signed in every case, in accordance with Regulation 12 (Regulation 12 (1)) 20/11/2011

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Reg. Requirement Due date

(2001) ensure that all parts of the home used by children are kept clean, reasonably maintained and free from hazards to their health or safety, with particular respect to hot and cold water, kitchen knives and chemicals, bedroom flooring, sand pit and slide (Reg 31 (2)(e) and 23 (a) 20/11/2011

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Reg. Requirement Due date

(2001) ensure that a written record is kept of any complaint, the action taken in response and the outcome of the investigation 20/11/2011 (Regulation 24 (5))

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Reg. Requirement Due date

(2001) ensure that the details of any accident are recorded in the child's case records (Regulation 28 (1) Schedule 3.21) 20/11/2011

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Reg. Requirement Due date

(2001) ensure that the visitor record includes the reasons for the visit (Regulation 29(1) Schedule 4.13) 20/11/2011

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Reg. Requirement Due date

(2001) establish a system for monitoring the matters in Schedule 6 at appropriate intervals and improving the quality of care provided. Ensure that the system provides for consultation with children, parents and placing authorities. (Regulation 34) 20/11/2011

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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 children are always given the opportunity to be examined by a medical practitioner or nurse when there has been physical restraint (NMS 3.16)  ensure that staff are clear about what responsibilities and decisions are delegated to them and work together effectively with parents, specifically with respect to the administration of pain relief medication to meet children's needs (NMS 6.5)  ensure that individual and homes risk assessments are promptly conducted and effectively taken into account in the planning and execution of children's activities, including activities outside and in the community (NMS 7.5)  ensure that the children's home has a record of the recruitment and vetting checks which have been carried out on those working in the home, including the matters listed in the minimum standard (NMS 16.3)  ensure that where only one member of staff is on duty that a written risk assessment has been carried out identifying any likely risks to children, staff and

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Recommendations

members of public (NMS 17.9)  ensure that staff understand the system for notifiable events, including what to do where such an event occurs at the weekend. (NMS 24.1)

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Outcomes for children and young people

Outcomes for children and young people are satisfactory .

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Outcomes for children and young people

Children develop an understanding of the setting and settle in well when they come for short breaks. No child stays overnight until they feel happy to do so and this may take months of gradual short introductions, according to the child’s individual needs. Children’s preferences and favourite toys and pastimes are carefully ascertained at the referral and care planning stage. This means that when they are there, each child can participate in a good range of opportunities and enjoy and achieve to their potential. Some children show noticeably improved behaviour as a result of staff’s work with them on issues about boundaries and personal space. Others enjoy and respond well to new stimulus, as staff share sensory objects such as water fountains or wind chimes with them.

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Outcomes for children and young people

Children’s general health is well supported and maintained when they are on short breaks. Children have good opportunities to make healthy food choices, such as fresh fruit smoothies. They also enjoy good amounts of exercise and fresh air in the well equipped play garden. For example, children enjoy the bucket swing, trampoline, slide and sand pit, as well as sensory plants. Walks and trips to suitable parks and leisure facilities also meet children’s individual health needs.

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Outcomes for children and young people

Children’s emotional health is fostered by caring and sensitive staff who spend quality time with children and understand how they communicate any distress, pain or discomfort. For example, staff might provide a foot massage, or relax in the sensory room alongside a child who finds this soothing.

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Outcomes for children and young people

Children’s attendance at school is good because the setting works cooperatively and supportively with schools and families. Staff ensure that morning care routines are completed in a timely way so that children are ready for the school transport to arrive and that they are assisted safely from the building and onto their transport to school.

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Outcomes for children and young people

Children are supported to make suitable progress in their learning because there is consistency of care and communication both at schools and in the setting. For example, communication boards, picture books and home/school books are shared between all the settings and staff keep up to date with any developments and changes in children’s care and communication routines.

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Outcomes for children and young people

Children enjoy good social opportunities with peers at the setting which enhances their social skills and their well-being. They make new friends here and can also enjoy the company of school friends in an informal atmosphere. For example, some children use the computer and television equipment to play games and use the internet together.

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Outcomes for children and young people

Children do not usually have contact with family members because the facility is for respite, but parents and siblings are welcomed into the setting if they wish and can stay and play at collection times. Overall, there is good communication to parents to provide reassurance as required to families while their child is at the service.

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Outcomes for children and young people

Children and young people are supported in accordance with their care plans towards increasing independence and maximising their potential. Where appropriate, young people learn to prepare food and to undertake simple shopping and self care tasks. Some young people are supported to use public transport and to conduct themselves in cafes and local leisure venues. Other children continue with their talents in art and choose from various art and craft media to make models and pictures of their favourite cartoon characters. Children who have significant health and mobility needs are able to enjoy maximum mobility around the setting and can bathe and shower in comfort, due to the excellent equipment and well trained staff.

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Quality of care

The quality of the care is satisfactory .

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Quality of care

Children are suitably cared for in line with their individual short break care plan. The contribution of the setting to those plans is generally of high quality and involves close liaison with families and other professionals involved with the child. Parents have described placement plans as ‘the best ever’, saying that they are ‘touched’ by the efforts of staff to identify and provide for their child.

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Quality of care

Each child’s cultural, religious and family practices are given suitable regard and there is particularly good work done to plan for children with complex health and/or behavioural needs. This ensures that the service meets the needs of all children and is fully accessible to all. However, not every placement plan has been completed, agreed and signed in accordance with the Regulations. This means that those with parental responsibility may not have sufficient knowledge of their child’s plan.

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Quality of care

Overall, children’s individual needs are met well. The home provides a range of accessible activities and staff actively seek children’s views and feelings. For example, some children choose to use the sensory room or the garden by selecting from photo cards of these places. Staff are attentive to meet children’s individual needs well by providing these choices. They also react sensitively and cooperatively to children’s responses to ensure that children retain as much dignity and control as possible.

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Quality of care

Risk assessments and care plans are not always used effectively enough to prepare for possible behaviour incidents and health needs. For example, there is usually one member of staff awake at night. This has not been effectively risk assessed however to ensure that adjustments to staffing levels are made when children’s behaviour and health needs require higher staffing levels. As a result, children requiring two staff to handle them safely have stayed at the same time as children who may display extremely challenging behaviour at night.

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Quality of care

Staff are proactive in preparing equipment and organising staffing levels and medication to ensure that children can continue to attend short breaks when they are in a post-operative state. However, they have not ensured in every case that children’s pain relief medication is sufficient to last the duration of the break.

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Quality of care

Children stay in a home which is appropriately located and designed. Equipment works well and provides for the health and well-being of children with both physical and learning disabilities. The setting provides a homely atmosphere and enables children to make choices, for example, of the room they would like to use which best accommodates their individual needs. However, the standard of maintenance and cleanliness in the kitchen, garden and some bedrooms has been compromised in a few instances. This is because some breakages, storage of hazardous items and poorly protected areas have not been promptly identified and rectified. Hot water is not working safely in all bedroom sinks and some flooring requires replacement. These shortfalls compromise the safety and well-being of children.

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Safeguarding children and young people

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

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Safeguarding children and young people

Children are safe and well protected overall whilst receiving short breaks care. This is because there is good security to the building which meets the needs of the children in attendance. Any activities taking place off site are also generally well planned. Staff usually take proper account of children’s assessed risks and parental consents. Staff are carefully vetted and recruited, although the setting itself does not have a record of their recruitment and vetting checks as required by the minimum standard. Nevertheless, staff are trained and competent in safe care practice, manual handling and child protection. As a result, children are well safeguarded overall.

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Safeguarding children and young people

Children’s safety is compromised because best practice is not followed in every case with regard to the recording of accidents, incidents, risk assessments, complaints and visitors. For example, parents have not been informed in every case of incidents that have happened whilst off site and the child’s case records are not complete in every case. In addition, risk assessments have not always been effectively made and used to identify some children’s needs when out near busy roads.

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Safeguarding children and young people

Complaints raised by parents about physical care issues have been resolved very effectively to parents’ complete satisfaction, but the complaint record does not cover all the details of the complaint itself, the action taken, and the outcome. Similarly, the visitor record does not give the details of the reason for the visit in a number of instances, making it unclear who was seen and where the visitor went.

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Safeguarding children and young people

Children’s behaviour is managed well. Careful consideration is given to the mix of children in attendance at any one time, and shifts are planned so that there are sufficient staff. In addition, staff follow individual children’s behaviour management plans carefully and create positive, calming and individualised environments according to each child’s individual needs.

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Safeguarding children and young people

Staff are well prepared to recognise triggers and know how to effectively de-escalate and distract children. As a result, the experience of short breaks is positive for children and they want to come. There have been no instances of children going missing and restraints are few, used only as a last resort and according to government guidance. Suitable records are made if there are restraints, but these do not clearly prompt staff to give children a choice about being medically checked after any restraint. Instead, records prompt staff to decide themselves whether medical treatment is necessary. Although this shortfall is minor, it compromises children's rights.

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Leadership and management

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

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Leadership and management

Children benefit from sound and effective management in the setting. For example, the provider meets the aims and objectives in the Statement of Purpose. Staff, parents and placing professionals are clear about the aims and objectives of the setting and the services and facilities that it provides. Parents and education colleagues are particularly pleased with the quality of the short breaks service and express high levels of confidence in it. Social work team managers state, for example, that 'the plans are carried out well for individual young people - they are really enjoying their time.'

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Leadership and management

Young people are looked after by staff who receive appropriate training and support. This includes both professional training for care and specific training from local professionals who form part of the individual child’s team. This ensures that children’s individual health, education and behaviour plans are effectively and consistently delivered to them, including at times of crisis. Supervision of staff is regular and effective in supporting staff to look after young people well. However, staff are not yet confident about the Regulation for notifiable events and a clear system has not been provided to train them on how to practice and record such events.

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Leadership and management

Management systems work well and support improving outcomes for children. However, the manager has not yet established a regular system for monitoring the setting and inform future planning and improvements for the benefit of young people. In addition, occasional errors in practice, recording and liaison have not been picked up through monitoring and promptly addressed. This impacts on the quality of provision that young people receive.

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Leadership and management

Equality and diversity practice is satisfactory .

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