Children's Home run by London Borough of Hounslow in Hounslow

Unique reference number SC032600 Inspection date 11/11/2011 Inspector David Putnam / Karen Malcolm Type of inspection Full Provision subtype Children's home

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Date of last inspection 09/02/2011 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 short break service provides care for up to five young people aged between 10 and 18 years of age who have either physical disabilities and/or special educational needs and who may also have a sensory impairment. The home is owned and operated by a local authority. The service operates every day, except Wednesdays.

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Overall effectiveness

The overall effectiveness is judged to be inadequate .

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Overall effectiveness

The overall effectiveness of this service is inadequate. Children and young people using the service are not currently safe because managers do not ensure that allegations made by children or young people are handled fairly, quickly and consistently in a way that provides effective protection for all children and young people. Safeguarding policies and training are out of date. There is no protocol in place relating to children or young people who go missing. Assessments of risk to health and safety are incomplete and inadequate.

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Overall effectiveness

Most children and young people using the short breaks service have little or no verbal communication. Staff use various approaches to ascertain their views, wishes and feelings. However, more could be done to achieve this. For example, a recommendation from the previous inspection to have clear procedures for dealing with informal complaints has not been progressed. The monthly monitoring visits carried out on behalf of the provider do not regularly include speaking with or observing children and young people in the home. The results of consultations are not collated promptly and it is difficult to see where children and young people have influenced improvements to the service. There is currently no system in place for the registered person to review the quality of care.

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Overall effectiveness

Despite the significant shortfalls, the outcomes for children and young people are good. The staff take time to get to know the children and young people well. They work directly with the children and young people, their families and other professionals to identify and meet individual needs in the best way they can. Short break care plans are in place for everyone using the service. Parents appreciate the service, and children and young people enjoy staying overnight. A range of activities in both the home and the wider community provide new experiences. Parents report that young people make progress in different ways. Particular attention is given to developing independence skills for a group of young people.

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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 all parts of the home to which children have access are so far as reasonably practicable free from hazards to their health or safety (Regulation 23(a)) 09/12/2011

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Reg. Requirement Due date

(2001) ensure that if, in relation to a children's home, any of the events listed in column 1 of the table in Schedule 5 takes place, the registered person shall without delay notify the persons indicated in respect of the event in column 2 of the table. (Regulation 30(1)) 09/12/2011

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Reg. Requirement Due date

(2001) ensure the person carrying out the visit shall interview, with their consent and in private, such of the children accommodated there, their parents, relatives and persons working at the home as appears necessary in order to form an opinion of the standard of care provided in the home. (Regulation 33(4)(a)) 31/12/2011

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Reg. Requirement Due date

(2001) establish and maintain a system for monitoring the matters set out in Schedule 6 at appropriate intervals; and improving the quality of care provided in the children's home. (Regulation 34(1)(a) & (b)) 11/01/2012

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Reg. Requirement Due date

(2001) ensure that all persons employed by him receive appropriate training, supervision and appraisal (Regulation 27(4)(a)) 31/01/2012

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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 the children's home procedure is in line with Government guidance and requirements including the duty to refer information to statutory bodies. It is know to staff, volunteers and children (NMS 20.2)  ensure that allegations against people that work with children are reported by the designated person to the Local Authority Designated Officer. This includes allegations that on the face of it may appear relatively insignificant or that have also been reported directly to the police or Children and Family Services (NMS 20.6)  ensure that risk assessments of the whole children's home environment are carried out, to identify any potential sources of harm to the children are recorded in writing and regularly reviewed (NMS 10.8)  ensure that avoidable hazards are removed as is consistent with a domestic setting (NMS 10.3)  ensure the manager regularly monitors, in line with regulations, all records kept

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Recommendations

by the home to ensure compliance with the homes policies, to identify any concerns about specific incidents and to identify patterns and trends. Immediate action is taken to address any issues raised by this monitoring (NMS 21.2)  make sure clear arrangements are in place to ensure appropriate management of the home when the registered manager is absent (NMS 21.5)  ensure that if a child is absent from the home and their whereabouts is not known (i.e. the child is missing), the home's procedures are compatible with and have regard to Runaway and Missing from Home and Care (RMFHC) protocols and procedures maintained and managed by the police or by the local authority for the area where the home is located. (NMS 5.6)

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Outcomes for children and young people

Outcomes for children and young people are good .

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Outcomes for children and young people

The children and young people's overall well-being is managed positively by staff and the health outcomes for those who use the service are good. As the home is a short breaks service, parents and carers generally remain responsible for meeting the overall healthcare needs of their children. The home often supports children and young people with very complex medical conditions and clear guidelines are in place to ensure that staff are consistent in their practice when meeting each child’s needs. Staff work very closely with children, young people and their families and, as a result, are able to meet their needs. Staff maintain good links with other professionals to ensure that the overall care of the child and young person is maintained not only within the unit but in their family home which gives a holistic approach to the child’s overall care.

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Outcomes for children and young people

Children and young people make good progress with their education. Although the education of the children and young people who use the service is the responsibility of their parents or carers, staff maintain good links with each child’s educational provision and strive to support them with their educational skills and development. Each child and young person has a copy of their individual personal education plan on file, so that staff are aware of their educational goals, achievements and progress. Staff also support children and young people with their homework and where appropriate retain a copy of school reports.

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Outcomes for children and young people

Contact with families is maintained to keep them up to date about any concerns or developments around their child’s care. Handover of information from staff to parents or carers ensures continuity of care for children and young people. Parents are reassured through the knowledge they can contact the home at any time. Information about any restrictions on contact is clearly recorded and there are also clear arrangements in place for who can collect a child or young person from the unit depending on the wishes of parents. Consequently children and young people are kept safe. Young people make good progress with their independent living skills. All young people are encouraged and supported to develop new skills that will enable them to be as independent as possible in preparation for moving on to adult services. The home has introduced a new semi-independence overnight stay for older young people at weekends. This is called the ‘My S.T.E.P.S project’. This involves

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Outcomes for children and young people

developing semi-independence training programmes for young people based on their individual needs and level of ability. For some this has included an independent travel and skills programme that supports them to learn to use public transport safely and prepare meals with minimum support. Young people are involved in recording their individual achievements in an appropriate format according to their understanding and ability. Pictures are frequently used as evidence or prompts.

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Quality of care

The quality of the care is satisfactory .

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Quality of care

Children and young people enjoy satisfactory relationships with experienced staff who are responsive to the individual needs of the children and young people who have short breaks overnight. Parents are positive about the staff and the standard of care provided. Attempts are made to ascertain the views, wishes and feelings of children and young people, but it is not always clear how the results of consultations are collated promptly to make improvements to the service for the children and young people.

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Quality of care

Records relating to medication are satisfactory. They provide a clear audit trail and evidence appropriate written communication with health professionals. Specific diagnoses of conditions are noted and information regarding individual conditions is contained on file. As a result staff have a better understanding of children and young people’s individual needs and specific treatments. Parents complete and sign epilepsy management agreements forms where appropriate. As a short break unit, health care is generally managed by parents on behalf of their children.

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Quality of care

The home is appropriately located within the community. The design of the building has taken into account the needs of the young people who use the service. Where necessary, adaptations are made to meet these needs. Contracts to maintain specific pieces of equipment are in place, but children and young people are affected by a lack of arrangements for monitoring the overall health and safety of the home. Key safety checks are considerably out of date and require urgent attention. Certain environmental risk assessments are not undertaken and other risk assessments are not reviewed and amended regularly to ensure that safety is not impinged. Insufficient attention is given to storing equipment safely or appropriately.

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Quality of care

Children, young people and their parents are able to complain if they are unhappy about any aspects of the service because the home has an appropriate complaints procedure. Parents said they would feel confident about raising any concerns or complaints with the manager. The children's guide contains a number of resources on DVD which are presented in a way which is creative and interesting for young people. This enables some of those using the service to access this information more easily, but is not accessible to all. Staff are aware that they can advocate on behalf of the children and young people in their care. This happens in regard to day-to-day care, but there are no records of formal complaints made on behalf of children and young people.

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Quality of care

Children and young people’s needs are detailed in short break care plans which demonstrate suitable liaison with families and other professionals. Staff take time to get to know the children and young people, their individual needs, likes and dislikes so they can meet their needs effectively. Individual dietary requirements for health, cultural or religious reasons are communicated to relevant staff and consistently respected. Children and young people are encouraged and enabled to make choices which promotes their independence.

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Quality of care

Children and young people benefit from taking part in a range of activities both in the home and out in the community, and their self-esteem and confidence is enhanced as a result. Staff respond to the likes and dislikes of children and young people. Recent trips have included a visit to the Olympic Park, going out for meals and to the cinema. Plans are in place for every young person to attend a local pantomime. A new project has been established which enables young people stay overnight to develop independence skills. A group from the project recently raised money for two charities by baking and selling cakes at the Civic Centre. The young people felt they had made a contribution to others in need. Their achievements were recognised by members of their community.

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Quality of care

Young people enjoy using the space within the home. The ground floor has a communal area that has a seating area, dining area and considerable space for activities. There is a sensory room and soft play area on the ground floor, as well as the shift office, kitchen, laundry room, bathroom and activity room with computer equipment for young people to use. Some young people use these facilities to enhance their learning, others use it for entertainment. They are supervised by staff at all times. All of the bedrooms are situated on the first floor along with further bathroom facilities and offices. There is a lift to the first floor ensuring all children and young people have equal access. There is a rear garden with play equipment for young people to use and a sensory garden.

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Quality of care

Children and young people using the service come from a wide range of cultural and religious backgrounds. The staff group reflects the diversity of the community in which the home is situated. Different religious or cultural festivals are acknowledged and celebrated. Information about a current religious festival was on display. One young person had chosen to use the computers in the home to research the information and present it for others. There is an impressive permanent mural on the wall of the main lounge. It is painted in three shades of grey and is calming rather than overpowering. It depicts a representative group of young people including an active wheelchair user providing positive images for children and young people to relate to.

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Safeguarding children and young people

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

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Safeguarding children and young people

Currently the service does not adequately safeguard children and young people. Not all staff have had recent training in child protection. The child protection policy available to staff is out of date. The current processes to notify appropriate professional agencies of significant safeguarding concerns are inadequate.

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Safeguarding children and young people

Systems to ensure the physical safety of the environment are inadequate. Records in the home show that key safety checks are significantly out of date. Health and safety checks covering all areas of the premises are not completed. Equipment is sometimes stored in places that are not safe or simply inappropriate. Combustible materials are stored close to potential sources of ignition. Items are left on the floor or leant against the wall of a corridor that forms an emergency escape route. Food is not always labelled and stored in sealed containers when opened. Items are stored under a low level work surface stopping wheelchair users from using this area properly. All these shortfalls compromise children and young people’s safety.

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Safeguarding children and young people

It is rare that children and young people go missing from the home, but this has occurred. Young people are able to leave the home undetected through fire doors that are not alarmed. There is no protocol in place with the local police regarding missing children as managers do not see this as applicable to the unit. This could result in a delayed or inappropriate response if a young person goes missing.

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Safeguarding children and young people

Physical restraint is used infrequently but appropriately. All staff receive training in a suitable technique from an accredited trainer from within the home's staff group. Any intervention uses the minimum force for the minimum period necessary. Records of restraints are sound, but although attempts are made to communicate with the child or young person afterwards this is not recorded. The use of restraint is monitored through the monthly visits undertaken on behalf of the registered provider. However, the registered person does not monitor the use and incidence of restraint as there is currently no established system for regularly reviewing and improving the quality of care.

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Safeguarding children and young people

The home is supported by the local authority to ensure that all recruitment checks for permanent and agency staff are completed properly to safeguard children and young people. Recording on staff files is clear.

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Safeguarding children and young people

Children and young people appear settled and content. When young people become distressed they are appropriately calmed and comforted by staff. Young people respond positively to staff and happily engage in activities with them or independently. Parents say their children feel safe when staying overnight at the unit. Parents report that their children become excited about going to the unit and say the name of the unit or of individual staff when they know they are going.

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Leadership and management

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

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Leadership and management

The current management arrangements of the home are not clear. A temporary arrangement has been in place whereby some of the Registered Manager’s responsibilities have been undertaken by an assistant manager. However, the Statement of Purpose continues to indicate that the Registered Manager is full time. A permanent change in arrangements is due to be made. It is important that Ofsted is informed of these changes as soon as they are confirmed. Children, young people and families will also need to be informed.

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Leadership and management

At the last interim inspection a recommendation was made that the home has clear procedures for dealing with and recording informal complaints. No progress had been made in implementing this recommendation. A system remains in place, but work with staff to implement this has not been undertaken. As a result not every opportunity to obtain children and young people’s views is taken.

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Leadership and management

Sufficient staff are employed to meet the needs of the children but training is inadequate. Key training in child protection, fire and food hygiene is not up to date. Not all members of staff receive regular supervision. Policies and procedures are inadequate. The home’s safeguarding policy requires updating. The vast majority of other policies are also out of date and the system in place for staff to sign they have read and understood these documents is not used. These shortfalls may result in inappropriate responses from staff as significant incidents or notifiable events arise. Managers do not ensure that allegations made by children or young people are handled fairly, quickly and consistently in a way that provides effective protection for all children and young people.

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Leadership and management

There is no system established under Regulation 34 for the registered person to review the quality of care. As a result the matters set out in Schedule 6 are not monitored and there is no clear plan to improve the overall quality of care provided to children and young people by the home.

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Leadership and management

Monthly visits, as required by Regulation 33, are undertaken regularly by different senior managers from the local authority. Reports from these visits provide scrutiny and highlight key issues. However, children and young people are rarely consulted or seen due to the timing of visits. There is also no evidence of parents being spoken to. Consequently valuable feedback from talking with or observing children and young people is missed. Equally the views of parents and carers do not contribute to the visitor’s opinion of the standard of care provided.

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Leadership and management

The home's Statement of Purpose is generally clear. The aims and objectives of the home are set out well and children, staff and the local authority are clear about the services provided. There is a commitment to recognising and meeting the individual needs of each young person who receives an overnight short break at the unit.

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Leadership and management

There are good relationships with some key outside agencies, in particular the local authority children's services and health professionals. Liaison with these key staff helps to improve understanding of individual needs and the provision of care. The quality of recording is acceptable and provides a good account of each young person's stay.

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Leadership and management

Equality and diversity practice is satisfactory .

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