Children's Home run by Action for Children Services Ltd in Buckinghamshire

Unique reference number SC424089 Inspection date 24/04/2012 Inspector Emeline Evans Type of inspection Full Provision subtype Children's home

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Date of last inspection 03/01/2012 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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Brief description of the service

This is a short breaks service for children and young people which is run by a national children's charity. The service can accommodate up to a total of 14 young people. The young people's needs range from moderate to severe learning disabilities, including physical disabilities and/or complex multiple needs. Many of the young people who use the service display challenging behaviours associated with their disability.

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Brief description of the service

The service provides for a significant proportion of young people in need of nursing input, as well as social care support.

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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 Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be adequate .

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Overall effectiveness

Young people are supported by a committed manager and experienced staff team. The staff team aim to ensure that the young people have a good time during their short-break visit.

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Overall effectiveness

Young people benefit from individualised care described as 'amazing' by one parent. Staff know the young people well and support them to progress in areas such as social development and independence. The staff team and the young people who stay at the home enjoy good relationships with each other. Staff use imaginative ways to gain the views of the young people. This provides young people with caring staff that understand their needs and challenging and complex behaviours.

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Overall effectiveness

Due to difficulties in recruiting to senior positions in the home, the manager has taken on additional roles. There is a priority of the manager and core staff team to meet the needs of the young people accessing the service. However, due to these additional responsibilities the manager does not have enough time to meet the full requirement of her role.

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Overall effectiveness

Young people comment that they feel safe and social workers and parents re-iterate this. Shortfalls identified relate to, a failure to update a behaviour management plan regarding the use of physical interventions and the recording systems when there have been a physical intervention; this means some staff may not be aware of the correct procedures to be followed and the shortfalls in recording make monitoring difficult. Additionally, some aspects of safe recruitment practices could not be evidenced for some staff members. This means it could not be evidenced that the home’s recruitment policy had been followed in every case. The manager is aware of the home’s shortfalls and is committed to further improve outcomes for the young people and provide a high quality service.

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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 the volume kept for the purpose of recording any measure of control, restraint or discipline includes all the information listed in the Regulations (Regulation 17B (3)(c)) 24/04/2012

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Reg. Requirement Due date

(2001) ensure that full and satisfactory information has been obtained and is available in relation to the matters specified in paragraphs 1 and 2 of Schedule 2 (Regulation 26 (6)(b)) 31/05/2012

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Reg. Requirement Due date

(2001) ensure the monitoring of matters set out in Schedule 6 shall provide for consultation with children, parents and placing authorities and the system focuses on improving the quality of care provided. (Regulation 34 (1(a)(2)) 31/05/2012

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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

 review the development plan to identify the future of the home and how the home will achieve outcomes for children (NMS 15.2)  ensure the overall number of staff employed in the home can fulfil the Statement of Purpose and meet the individual needs of the children (NMS 17.1)  enable the children to know who is working in the home in the day and at night (NMS 17.12)  ensure the staff are equipped with the skills to meet the needs of the children. In particular, this relates to training in communication systems and autistic spectrum disorders (NMS 18.1)  ensure the manager is able to easily access all on line training records in the home. (NMS 21.2)  ensure children’s placement plans identify specific strategies that have been agreed to reduce the incidences of any negative behaviour; with specific reference to ensuring that the plans are regularly reviewed and up dated. (Children Act 1989 Statutory guidance Volume 5, 2.88)

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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

Young people benefit from personalised care during their stay, which helps them grow in confidence and promotes all aspects of their individual identity. Staff are skilled at understanding and interpreting ways in which young people express their needs. This ensures young people’s emotional well-being is central to all aspects of care planning and intervention.

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Outcomes for children and young people

Young people benefit from these brief periods way from home; they are purposeful and young people develop new social skills and are supported to make decisions in order to maximise their independence. Young people engage in all sorts of activities in the community and are encouraged to learn and try new experiences when visiting the home. Staff ensure that young people make good use of age appropriate local amenities such as parks, restaurants and the cinema. This provides the young people with opportunities for social interaction to be further enhanced. One parent commented ‘my son has moved on and become more sociable since coming to the service’ and ‘my child gets to see and interact with other children.’

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Outcomes for children and young people

Young people have access to a wide variety of activities within the home including, musical instruments and sensory items. They also play in the large garden area and sensory room. Young people are supported to contribute to the up keep of a vegetable patch in the garden; this has enabled young people to start to take responsibility and therefore enhance their self-esteem. Comments from parents include ‘he is involved in lots of activities in the home which is great.’ The opportunities provided are enabling young people’s social and emotional development to progress.

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Outcomes for children and young people

Young people’s educational needs are well supported. Staff ensure there is good communication with the schools and have books in place to maintain regular contact; this is ensuring a holistic approach is maintained. Staff participate in young people’s educational reviews and work closely with school teachers with regard to individual needs; this ensures a consistent approach is achieved.

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Outcomes for children and young people

Young people receive positive care, which promotes their independence. Staff support young people, in a way that meets their age and understanding, to develop practical skills such as personal self-care and daily living skills. There have been measurable outcomes achieved in these areas. Young people are now able to sit independently at the table and they take an active role in personal care routines. A parent commented ‘my son is much more independent in personal care because we have all worked together.’

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Quality of care

The young people benefit from good supportive relationships from committed and experienced staff members. Comments from a social worker include ‘the staff have very specialist ways of supporting the young person and they know and understand her well.’ A parent commented ‘staff are great, I trust them they are amazing.’ Staff interact with children using appropriate verbal signs and alternative methods of communication. Staff are aware of and observe non-verbal communication and are proactive in reassuring young people during difficult times. They do this using a sensitive approach and a good understanding of their needs. The staff team is supporting young people to be able to express their views through participation meetings. Young people are involved and supported to make their views known about the running of the home. A recent meeting enabled young people to choose the name of the new activity room. This resulted in young people feeling that their

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Quality of care

views are actively sought and that they can see the result. Young people are able to make daily choices during their stays for example in relation to snacks, drinks and activities.

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Quality of care

Young people can access child-friendly complaints forms; these are appropriate to their level of understanding. A young person commented 'I am listened to and can talk to someone if I feel sad.' Since the last inspection there have been a number of complaints from parents; the manager has been proactive in addressing these concerns and has worked, with outside professionals in some instances, to resolve the matters. The manager has taken action to fully investigate all complaints. This holistic approach demonstrates the home’s capacity to act upon feedback in order to improve outcomes and the quality of care for the young people.

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Quality of care

Young people are cared for in line with detailed and comprehensive placement plans. Individual needs are identified and understood by staff. Placement plans take into account the diverse and complex needs of the young people accessing the service including their medical, health and cultural needs and additional support required due to disability; a shortfall in one plan is discussed under the safeguarding section. One social worker commented ‘the home is very good at adapting the young person’s placement plan and communicating this to all involved.’ This practice is ensuring a consistent approach is achieved. Arrangements for dealing with medication are safe and managed by trained and experienced staff. There is a clear audit trial of medication coming into and leaving the unit. There is appropriate attention provided to any emerging or on-going health or emotional needs. Staff work closely with the young people’s families and community nurses to monitor

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Quality of care

young people’s health during their stays and respond appropriately to any concerns. This ensures continuity of care is achieved.

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Quality of care

The home provides a safe and pleasant environment in which young people enjoy their stays. The accommodation provides good spaces for group and individual activities. The home has appropriate specialist equipment to assist in delivering personal care needs and to ensure the individual needs of the young people accessing the service are met; such as ceiling hoists and adapted baths. The home is well resourced to stimulate young people and promote sensory development through the use of the sensory room, garden and activity rooms. Due to the size of the children’s home, it is difficult to determine which staff are on duty. Due to the difficulties, some young people experience around transition and routine a recommendation has been raised to further improve the quality of care provided in this area.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people say they feel safe in the home; staff receive training on safeguarding and recognise the particular vulnerabilities relating to the needs of children with disabilities. The policies and procedures in relation to safeguarding are readily available to staff and the home implements measures to minimise identified risks through one-to-one supervision and staff meetings. The home has implemented a DVD on bullying after group discussion. This has been successful and supports young people with complex needs to understand the importance of being protected from harm such as bullying. One person commented ‘yes’ when asked if he felt safe.

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Safeguarding children and young people

Short-break placement plans identify risks for individual young people and preventative measures. Most of these are clear and comprehensive and inform the staff of appropriate action to take. Behaviour management plans are sound. However, one plan had not been updated and this could mean that staff are not clear about the correct action to take when specific behaviours occur. Additionally the recording systems for physical intervention measures used do not enable the Registered Manager to monitor the use and the effectiveness of certain interventions.

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Safeguarding children and young people

Full recruitment records for the children’s home are not maintained at the home. However, all staff have satisfactory Criminal Records Bureau checks. The information in relation to references obtained for staff was incomplete. This meant that, while records showed that references had been obtained for new members of staff, it was not possible to establish if references had been obtained for longer standing members of staff.

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Safeguarding children and young people

Written procedures are in place for responding to incidents if a young person is missing from the home; there have been no related incidents. Staff are aware of procedures to be followed in the event of this occurring.

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Safeguarding children and young people

Young people are protected by sound health and safety routines. Regular fire alarm tests take place and staff work with individual young people to prepare them for the action to take in the event of fire or an emergency.

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Leadership and management

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

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Leadership and management

Young people benefit from a Registered Manager and core staff team who are committed to improvements and have high aspirations for the young people they support. However, the Registered Manager has had difficulties in recruiting to senior positions within the home and has therefore taken on additional roles within the staff team. Staff shortages within the home could impact on the service being able to meet the individual needs of the young people accessing the service. The manager is actively trying to recruit to the vacant positions.

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Leadership and management

The manager is aware of the shortfalls within the home and is working with the staff team to further improve the quality of care. There is a development plan in operation, however this has not been reviewed recently and it has a focus on staff’s concerns rather than on the future of the home or areas for improving outcomes for young people.

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Leadership and management

The Statement of Purpose clearly states the aims and objectives of the service and the facilities it provides. There is a clear focus on working in partnership with young people, parents and outside professionals to achieve a consistent approach to meeting the needs of young people. The young people’s guide is informative and comprehensive and is suitable for the young people’s level of understanding. There are plans to transfer the young people’s guide on to a DVD; this additional aid will support young people with more complex needs to understand the aims of the home. There are regular visits under Regulation 33 of the Children’s Homes Regulations, and the Registered Manager undertakes Regulation 34 checks on a regular basis. However, the Regulation 34 reports presently in operation do not indicate that routine consultation with young people, parents and placing authorities takes place and how this monitoring is used to further improve the quality of care

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Leadership and management

Staff benefit from regular supervision and staff meetings ensuring they have the opportunity to raise any issues as they arise. They are able to discuss strategies for supporting young people and share good practice during this time. Staff are equipped with the necessary skills to support young people through a regular training program. However, staff have not recently received training to meet the individual needs of the young people presently accessing the service. This specifically relates to training in communication systems and autistic spectrum disorders. This lack of training in these areas does not enable staff to keep up to date with current practice. Information relating to online training undertaken by staff is not easy to access thus during the monitoring of the home; the manager is unable to have this information readily available.

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Leadership and management

The physical environment is well maintained and issues of health and safety are monitored. Regular servicing ensures the safety of the appliances. Individual plans for young people are in operation. These measures ensure young people are protected from immediate risk. Records are clear and comprehensive and contribute to an understanding of the young person’s life; this will be helpful for their future.

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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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